M F FERNANDEZ MD KELLY MEDICAL CENTER CO INC (NPI# 1245381052) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245381052 |
| Entity Type | Organization |
| Organization Name | M F FERNANDEZ MD KELLY MEDICAL CENTER CO INC |
| Practice Address |
29613 Sw 162nd Ave Homestead FL 33033-3328 |
| Practice Telephone | 3052457787 |
| Practice Fax Number | 3052457740 |
| Mailing Telephone | 3052457787 |
| Mailing Fax Number | 3052457740 |
| Enumeration Date | 2007-01-16 |
| Last Update Date | 2008-07-01 |
| Authorized Official Name | MANUEL F FERNANDEZ (OWNER) |
| Authorized Official Telephone | 3052457787 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208D00000X | General Practice | ME66369 | FL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 373393901 | 05 |
| Street Address |
29613 SW 162ND AVE |
| City | HOMESTEAD |
| State | FL |
| Zip Code | 33033-3328 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003451832 | Rodolfo Sigler | Pharmacist | 1499 South Dixie Highway, Homestead, FL 33033 | 2019-11-15 |
| 1891337119 | Ricardo Saez | Nurse Practitioner | 2936 Se 3rd Street, Homestead, FL 33033 | 2019-10-09 |
| 1164904876 | Mayrelis Rodriguez Chaviano | Behavior Technician | 1510 E Mowry Dr Apt 107, Homestead, FL 33033 | 2018-08-30 |
| 1598252470 | Mcdivitt Arnold | Community/Behavioral Health | 945 Ne 34 Ave, 104, Homestead, FL 33033 | 2018-04-17 |
| 1972007870 | Anaivys Gomez Abreu | Behavior Technician | 1504 E Mowry Dr Apt 101, Homestead, FL 33033 | 2018-03-23 |
| 1023519261 | Lifeway Programs LLC | Community/Behavioral Health | 15300 Sw 288th St, Homestead, FL 33033 | 2018-02-22 |
| 1447759964 | Yaneisis Salazar Barata | Physical Therapy Assistant | 31 N Krome, Homestead, FL 33033 | 2018-02-10 |
| 1184132763 | C.o.r. Injury Centers of Homestead Inc. | Clinic/Center | 15600 Sw 288th Street, Homestead, FL 33033 | 2018-01-17 |
| 1790299949 | Aidalis Hechavarria | Behavior Technician | 1548 Ne 8th St Apt 105, Homestead, FL 33033 | 2017-11-27 |
| 1053839621 | Generosa E Gonzalez | Behavior Technician | 30322 Sw 161 Ave, Homestead, FL 33033 | 2017-09-05 |
| Find all providers in zip 33033 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336708478 | Ramiro Rodriguez | General Practice | 290 Ne 8th St, Homestead, FL 33030-4710 | 2019-06-12 |
| 1720482656 | Homeland Health Solutions, Inc | General Practice | 445 N Krome Ave, Homestead, FL 33030-6040 | 2014-10-21 |
| 1003157017 | Tomas Wharton | General Practice | 311 Ne 8th St Ste 110, Homestead, FL 33030-4734 | 2013-03-15 |
| 1265780514 | Jorge Adalberto Aguilar | General Practice | 19000 Sw 377th. Street, Dade Correctional Institution, Homestead, FL 33034 | 2012-08-16 |
| 1043531304 | Eddunio Gomez M.d. P.a. | General Practice | 17 Ne 9th Ct, Homestead, FL 33030-4611 | 2010-06-21 |
| 1487859245 | Homestead Medical Clinic, P.a | General Practice | 43 Ne 15th St, Homestead, FL 33030-4506 | 2007-06-20 |
| 1508901521 | Jorge Rafael Delgado | General Practice | 19000 Sw 377th St, Homestead, FL 33034 | 2007-02-20 |
| 1518060409 | Jose O De Los Santos | General Practice | 120 N.w. 12 St., Homestead, FL 33030 | 2006-09-06 |
| 1669481487 | Milady Belisa Fernandez | General Practice | 38 Nw 8th St, Homestead, FL 33030 | 2006-08-08 |
| 1851330989 | Ruben J Nunez | General Practice | 15260 Sw 280th St, 116, Homestead, FL 33032-8185 | 2006-06-05 |
| Find all providers in HOMESTEAD | ||||
Please comment or provide details below to improve the information on M F FERNANDEZ MD KELLY MEDICAL CENTER CO INC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.