Provider Demographics
NPI:1043619273
Name:MARIZ, FERNANDO TEMPORAL (MD)
Entity type:Individual
Prefix:DR
First Name:FERNANDO
Middle Name:TEMPORAL
Last Name:MARIZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:78 RIDGE ST APT 2E
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10002-3565
Mailing Address - Country:US
Mailing Address - Phone:727-729-0149
Mailing Address - Fax:
Practice Address - Street 1:222 E 34TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-4842
Practice Address - Country:US
Practice Address - Phone:646-290-9560
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-13
Last Update Date:2024-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY293400207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology