| Name: | Raymond N. Fernandez, M.D., P.C. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Professional Corporation |
| Status: | Exists |
| Date of registration: | 29 Apr 2003 (22 years ago) |
| Entity Number: | 000-228-795 |
| Register Number: | 000228795 |
| County: | Etowah |
| Place of Formation: | Etowah County |
| Principal Address: | GADSDEN, AL |
| Registered Office Street Address: | 105 DUNCAN CTGADSDEN, AL 35904 |
| Registered Office Street Address ZIP Code: | 35904 |
| Authorized Capital: | $5,000 |
Activities
PROFESSIONAL MEDICAL SERVICES
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1376680744 | 2007-02-01 | 2007-10-15 | 4198 US HIGHWAY 431 STE A, ALBERTVILLE, AL, 359500242, US | 4198 US HIGHWAY 431 STE A, ALBERTVILLE, AL, 359500242, US | |||||||||||||||||||||||||
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| Phone | +1 256-891-8580 |
| Fax | 2568918581 |
Authorized person
| Name | DR. RAYMOND N FERNANDEZ |
| Role | PRESIDENT |
| Phone | 2568918580 |
Taxonomy
| Taxonomy Code | 207RC0000X - Cardiovascular Disease Physician |
| License Number | MD.22283 |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BCBS OF AL PROVIDER NUMBE |
| Number | 51515286 |
| State | AL |
| Name | Role |
|---|---|
| FERNANDEZ, RAYMOND N | Agent |
| Name | Role |
|---|---|
| FERNANDEZ, RAYMOND N | Incorporator |
Date of last update: 02 Aug 2024
Sources: Alabama Secretary of State
