Basic Information
| Provider Information | |||||||||
| NPI: | 1881246296 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | FERNANDEZ SANCHEZ | ||||||||
| FirstName: | MARCO | ||||||||
| MiddleName: | ANGELO | ||||||||
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| Credential: | APRN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1000 45TH ST | ||||||||
| Address2: | STE 100 | ||||||||
| City: | WEST PALM BEACH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 334072416 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5616858892 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1250 SOUTHWINDS DR | ||||||||
| Address2: | |||||||||
| City: | LANTANA | ||||||||
| State: | FL | ||||||||
| PostalCode: | 334621459 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5616591270 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/15/2019 | ||||||||
| LastUpdateDate: | 11/29/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 11/29/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | 11003163 | FL | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.