| Name: | Frederico Fernandez, MD, P.C. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Professional Corporation |
| Status: | Exists |
| Date of registration: | 10 Aug 2000 (24 years ago) |
| Entity Number: | 000-211-453 |
| Register Number: | 000211453 |
| County: | De Kalb |
| Place of Formation: | DeKalb County |
| Principal Address: | VALLEY HEAD, AL |
| Registered Office Street Address: | 126 COMMERCE AVEVALLEY HEAD, AL 35989 |
| Registered Office Street Address ZIP Code: | 35989 |
| Authorized Capital: | 1,000 |
Activities
PRACTICE OF MEDICINE
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1710110945 | 2009-09-04 | 2009-09-04 | 2804 GREENHILL BLVD NW STE 101, FORT PAYNE, AL, 359683067, US | 2804 GREENHILL BLVD NW STE 101, FORT PAYNE, AL, 359683067, US | |||||||||||||||||||
|
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| Phone | +1 256-845-0023 |
| Fax | 2568450238 |
Authorized person
| Name | DR. FREDERICO YAMBAO FERNANDEZ |
| Role | PRESIDENT |
| Phone | 2568450023 |
Taxonomy
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| License Number | MD.21001 |
| State | AL |
| Is Primary | Yes |
| Name | Role |
|---|---|
| FERNANDEZ, FREDERICO | Agent |
| Name | Role |
|---|---|
| FERNANDEZ, FREDERICO | Incorporator |
Date of last update: 01 Aug 2024
Sources: Alabama Secretary of State
