Provider Demographics
NPI:1053598714
Name:FERNANDES, CIPRIANO S (MD)
Entity type:Individual
Prefix:
First Name:CIPRIANO
Middle Name:S
Last Name:FERNANDES
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1200 NE 55TH BLVD
Mailing Address - Street 2:NORTH FLORIDA EVAL/TREATMENT CENTER
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32641-2783
Mailing Address - Country:US
Mailing Address - Phone:352-375-8484
Mailing Address - Fax:352-271-4563
Practice Address - Street 1:1200 NE 55TH BLVD
Practice Address - Street 2:NORTH FLORIDA EVAL/TREATMENT CENTER
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32641-2783
Practice Address - Country:US
Practice Address - Phone:352-375-8484
Practice Address - Fax:352-271-4563
Is Sole Proprietor?:No
Enumeration Date:2008-01-24
Last Update Date:2008-01-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME338022084F0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084F0202XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyForensic Psychiatry