Most Relevant Information
Provider Data
| NPI Number: | 1003598509 |
| Provider Name: | KYLE FERNANDEZ PA-C |
| Entity Type: | Individual |
| Taxonomy Code: | 363A00000X |
| Specialty: | Physician Assistant |
| License Number: | PA9554 |
Most Important Dates
| Enumeration Date: | 08/03/2023 |
| Last Updated: | 08/30/2023 |
Provider Practice Location
55 LAKE AVE N
WORCESTER
MA
016550002
Practice Location Phone/Fax
| Phone: | 5083348515 |
| Fax: | 5083346490 |
Provider Mailing Location
PO BOX 415348
BOSTON
MA
022415348
Provider Mailing Phone/Fax
| Phone: | 8002258885 |
| Fax: | 5083341977 |