Provider Demographics
NPI:1548009038
Name:SAMADA FERNANDEZ, KAREL
Entity type:Individual
Prefix:
First Name:KAREL
Middle Name:
Last Name:SAMADA FERNANDEZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16520 SW 137TH AVE APT 1037
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33177-2302
Mailing Address - Country:US
Mailing Address - Phone:786-325-1974
Mailing Address - Fax:
Practice Address - Street 1:16520 SW 137TH AVE APT 1037
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33177-2302
Practice Address - Country:US
Practice Address - Phone:786-325-1974
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-23
Last Update Date:2024-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist