MEDICARE: MARA FERNANDA CUBEROS DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	DN24469	FL

General Provider Information

NPI Number	:	1841726130
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARA FERNANDA CUBEROS DDS

Provider Business Mailing Address
First Line	:	3621 TURTLE RUN BLVD APT 1023
Second Line	:
City	:	CORAL SPRINGS
State	:	FL
Zip	:	33067-4241
Country	:	US
Telephone Number	:	954-278-4519
Fax Number	:

Provider Business Practice Location Address
First Line	:	1875 S UNIVERSITY DR
Second Line	:
City	:	DAVIE
State	:	FL
Zip	:	33324-5805
Country	:	US
Telephone Number	:	954-320-9555
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/04/2017
Last Update Date	:	05/16/2024

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