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DR. LUIS ENRIQUE FERNANDEZ
NPI 1063866234
General Practice in Port St Lucie, FL

Active since April 14, 2016PECOS Enrolled
1170 SW BAYSHORE BLVD STE 200, PORT ST LUCIE, FL 34983(772) 309-0020(855) 538-3104 Get Directions Write a Review

NPPES record last updated: October 14, 2025. Verified against the NPPES registry weekly; last sync: September 06, 2026.

About Dr. Luis Enrique Fernandez NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. LUIS ENRIQUE FERNANDEZ (NPI 1063866234) is an individual general practice provider in Port St Lucie, Florida, licensed in Florida (ACN1761) and active in the NPI registry since April 2016. He is enrolled in Medicare PECOS and is a graduate of Other (1995).

NPPES Registry Identity

NPI1063866234
Entity TypeIndividualMale
Primary Taxonomy208D00000X
Provider Legal NameDR. LUIS ENRIQUE FERNANDEZ
Location Address1170 SW BAYSHORE BLVD STE 200Port St Lucie, FL 34983-2408
Mailing Address1170 Sw Bayshore Blvd Ste 200Port St Lucie, FL 34983-2408 · (772) 309-0020 · Fax (855) 538-3104
Phone(772) 309-0020
Fax(855) 538-3104
Sole ProprietorYes
Medical School CMSOtherGraduated 1995
Enumeration DateApril 14, 2016
Last NPPES UpdateOctober 14, 2025
NPPES CertifiedOctober 14, 2025
✔ NPI 1063866234 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyGeneral PracticeAllopathic & Osteopathic Physicians
Taxonomy Code208D00000X
Licenses✔ Licensed in FL · ACN1761✔ Licensed in PR · 19469
Definition
A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee
1170 SW BAYSHORE BLVD STE 200, Port St Lucie, FL 34983
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Other Names 1

Professional Name (2)Luis Fernandez M.d.

Other Identifiers 1

Other13786-IPR · Junta Medica De Pr

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Luis Enrique Fernandez is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID1153725486
PECOS Enrollment IDI20251111003958
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SOMA MEDICAL CENTER, P.A.
Clinic/Center (Primary Care)
1170 SW BAYSHORE BLVD STE 200
PORT ST LUCIE, FL 34983
St. Lucie County (564) 964-4577

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Luis Fernandez's NPI number?

The NPI number for Luis Fernandez is 1063866234. It was assigned to this individual provider in the NPPES registry on April 14, 2016. The provider is also known as Luis Fernandez M.D..

Where is Luis Fernandez located?

Luis Fernandez practices at 1170 SW Bayshore Blvd Ste 200, Port St Lucie, FL 34983. The listed phone number is (772) 309-0020.

What is Luis Fernandez's specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

Is Luis Fernandez enrolled in Medicare?

Yes. Luis Fernandez is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Luis Fernandez was last updated on October 14, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.