Provider Demographics
NPI:1912889221
Name:MICHELLE MARIE FERNANDEZ
Entity type:Organization
Organization Name:MICHELLE MARIE FERNANDEZ
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:FERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:PA
Authorized Official - Phone:786-973-5441
Mailing Address - Street 1:8585 SW 148TH TER
Mailing Address - Street 2:
Mailing Address - City:PALMETTO BAY
Mailing Address - State:FL
Mailing Address - Zip Code:33158-1941
Mailing Address - Country:US
Mailing Address - Phone:786-973-5441
Mailing Address - Fax:
Practice Address - Street 1:8585 SW 148TH TER
Practice Address - Street 2:
Practice Address - City:PALMETTO BAY
Practice Address - State:FL
Practice Address - Zip Code:33158-1941
Practice Address - Country:US
Practice Address - Phone:786-973-5441
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-25
Last Update Date:2025-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty