Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Luis Enrique Fernandez

Individual provider General Practice Physician · NPI 1063866234

Dr. Luis Enrique Fernandez is a General Practice in Port St Lucie, Florida. Qualified in 1995, 31 years ago. Practices as a sole proprietor. Licensed in Florida and Puerto Rico.

Years since qualifying
31
Licensed in
FL, PR
In the registry since
2016
Specialties on file
2
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Practice location Address checks out

1170 SW Bayshore Blvd Ste 200
Port St Lucie, FL 34983-2408
Phone: (772) 309-0020
Fax: (855) 538-3104
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

General Practice Physician (primary) Taxonomy 208D00000X · Licence ACN1761 (FL)
General Practice Physician Taxonomy 208D00000X · Licence 19469 (PR)

Record details

NPI number1063866234
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedApril 14, 2016
Last updated in NPPESOctober 14, 2025
Certification dateOctober 14, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyGENERAL PRACTICE
Medical schoolOTHER
Graduated 1995 (31 years in practice)
Accepts Medicare assignment Not indicated
Practice locations3 on file with Medicare

Other providers in Port St Lucie