Provider Demographics
NPI:1538185939
Name:FERNANDEZ-SALVADOR, VERONIQUE (MD)
Entity type:Individual
Prefix:
First Name:VERONIQUE
Middle Name:
Last Name:FERNANDEZ-SALVADOR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:VERONIQUE
Other - Middle Name:
Other - Last Name:TRAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2234 COLONIAL BOULEVARD
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33907-1412
Mailing Address - Country:US
Mailing Address - Phone:239-931-7342
Mailing Address - Fax:239-931-7385
Practice Address - Street 1:7451 GLADIOLUS DR
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33908-5193
Practice Address - Country:US
Practice Address - Phone:239-689-8800
Practice Address - Fax:239-790-5471
Is Sole Proprietor?:No
Enumeration Date:2006-07-15
Last Update Date:2016-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME96165208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL54326OtherBCBS PROVIDER NUMBER
FL7369781OtherAETNA PROVIDER #
FLU8195VOtherMEDICARE FOR LAB LOCATION
FL0466227-001OtherCIGNA PROVIDER #
FL273627300Medicaid
FLME96154OtherMETCARE PROVIDER #
FL11621OtherUNIVERSAL HEALTHCARE
FL1193028OtherWELLCARE
FLP00344546OtherRAILROAD MEDICARE PIN #
FL1538185939OtherMD MEDICARE CHOICE
FLP00471488OtherRAILROAD MEDICARE
FL11621OtherUNIVERSAL HEALTHCARE
FL1538185939OtherMD MEDICARE CHOICE
FLI61698Medicare UPIN
FLU8195XMedicare PIN