Individual provider Active NPI

Maria Victoria Fernandez, MD

  • Pediatrics Physician
  • Hialeah, FL
National Provider Identifier
1962450072
Registry record updated Jan 22, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
ME61882 Issued in FL
Practice address
3750 W 16TH Ave
Hialeah, FL 33012-4654
Phone
(305) 821-1600
Fax
(305) 821-1632
NPI assigned
May 4, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X ME61882 FL Primary

Addresses

Primary practice location

3750 W 16TH Ave
Hialeah, FL 33012-4654

Mailing address

13173 SW 47TH St
Miramar, FL 33027-3163
Phone (305) 336-6726

Other practice location 1

801A W 48th St
Hialeah, FL 33012-3541
Phone (305) 821-1600

Other identifiers 1

IdentifierTypeStateIssuer
371545101MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110927000451 FL Order and Referring Only - Pediatric MedicinePractitioner - Pediatric Medicine 6406027234

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME61882FLMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kid Care Pediatrics, P a Pediatrics Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1146700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1516579200000",
    "number": "1962450072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13173 SW 47TH ST",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "330273163",
            "telephone_number": "305-336-6726",
            "fax_number": "305-821-1632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3750 W 16TH AVE",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330124654",
            "telephone_number": "305-821-1600",
            "fax_number": "305-821-1632"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "801A W 48th St",
            "address_purpose": "LOCATION",
            "city": "Hialeah",
            "state": "FL",
            "postal_code": "330123541",
            "country_code": "US",
            "telephone_number": "305-821-1600",
            "fax_number": "305-821-1632",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FERNANDEZ",
        "first_name": "MARIA",
        "middle_name": "VICTORIA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-04",
        "last_updated": "2018-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME61882",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "371545101",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hialeah, FL

Sources for this page

Verify at the official NPI Registry.