| Dr Luis Enrique Fernandez, | |
|
1170 Sw Bayshore Blvd Ste 200, Port St Lucie, FL 34983-2408 | |
| (772) 309-0020 | |
| (855) 538-3104 |
| Full Name | Dr Luis Enrique Fernandez |
|---|---|
| Gender | Male |
| Speciality | General Practice |
| Location | 1170 Sw Bayshore Blvd Ste 200, Port St Lucie, Florida |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063866234 | NPI | - | NPPES |
| 13786-I | Other | PR | JUNTA MEDICA DE PR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | ACN1761 (Florida) | Primary |
| 208D00000X | General Practice | 19469 (Puerto Rico) | Secondary |
| Entity Name | Instituto Medico Del Norte Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1154309169 PECOS PAC ID: 5597728816 Enrollment ID: O20061116000444 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Luis Enrique Fernandez, 1170 Sw Bayshore Blvd Ste 200, Port St Lucie, FL 34983-2408 Ph: (772) 309-0020 | Dr Luis Enrique Fernandez, 1170 Sw Bayshore Blvd Ste 200, Port St Lucie, FL 34983-2408 Ph: (772) 309-0020 |
Regine Dorvil, MD General Practice Medicare: Accepting Medicare Assignments Practice Location: 671 Se Port St Lucie Blvd, Port St Lucie, FL 34984 Phone: 772-353-5716 Fax: 844-367-0091 | |
Debbie Michelle Sevilla, MD General Practice Medicare: Not Enrolled in Medicare Practice Location: 672 Sw Prima Vista Blvd Ste 101, Port St Lucie, FL 34983 Phone: 772-905-2555 Fax: 772-336-8153 | |
Miguel Angel Gonzalez Perez, MD General Practice Medicare: Accepting Medicare Assignments Practice Location: 9109 S Us Highway 1 Ste 101, Port St Lucie, FL 34952 Phone: 772-398-1305 Fax: 772-398-1307 | |
Brittany Nobilette, D.O. General Practice Medicare: Accepting Medicare Assignments Practice Location: 1800 Se Tiffany Ave, Port St Lucie, FL 34952 Phone: 772-335-4000 | |
Jorge Manuel Gomez Vizcarra, MD General Practice Medicare: Accepting Medicare Assignments Practice Location: 1100 Sw Saint Lucie West Blvd Ste 209, Port St Lucie, FL 34986 Phone: 772-204-8889 Fax: 772-204-8895 | |
Dr. Jacqueline Stephanie De La Cruz, MD General Practice Medicare: Accepting Medicare Assignments Practice Location: 9109 S Us Highway 1 Ste 101, Port St Lucie, FL 34952 Phone: 772-398-1305 Fax: 772-398-1307 |