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Andre Lage Fernandes
Student in an Organized Health Care Education/Training Program in Tampa, Florida
NPI 1669981726

Andre Lage Fernandes is a Student in an Organized Health Care Education/Training Program based in Tampa, FL. Andre Lage Fernandes practices in Tampa, FL. The NPI Number for Andre Lage Fernandes is 1669981726 and holds a License No. PSI33186 (Florida).

The current practice location address for Andre Lage Fernandes is 12901 Bruce B Downs Blvd, Tampa, FL and can be reached out via phone at 813-974-5699.

Location: 12901 Bruce B Downs Blvd, Tampa, FL, 33647-2632
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1669981726
Provider Name
Andre Lage Fernandes
Credential
Provider Entity Type
Individual
Gender
Male
Address
12901 Bruce B Downs Blvd, Tampa, FL, 33647-2632
Phone Number
813-974-5699
Fax Number
Provider Enumeration Date
09/21/2017
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
12901 Bruce B Downs Blvd
City
Tampa
State
Florida
Zip
33612-4742
Phone Number
813-974-5699
Fax Number
person
Provider Business Mailing Address Details
Address
12901 Bruce B Downs Blvd
City
Tampa
State
Florida
Zip
33612-4742
Phone Number
813-974-5699
Fax Number
person
Provider's Taxonomy Details 1
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
PSI33186 (Florida)
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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