Provider Demographics
NPI:1174247290
Name:FERNANDEZ, CHRISTINA FRANCESCA
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:FRANCESCA
Last Name:FERNANDEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7800 SW 57TH AVE STE 205
Mailing Address - Street 2:
Mailing Address - City:SOUTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33143-5542
Mailing Address - Country:US
Mailing Address - Phone:305-854-2471
Mailing Address - Fax:305-854-0811
Practice Address - Street 1:7800 SW 57TH AVE STE 205
Practice Address - Street 2:
Practice Address - City:SOUTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33143-5542
Practice Address - Country:US
Practice Address - Phone:305-854-2471
Practice Address - Fax:305-854-0811
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-03
Last Update Date:2022-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSI5282235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLSI5282OtherASHA