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General NPI Number Information
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NPI Number | 1740756063
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Entity Type | Individual
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Provider Name | MALENA PATRICIA FERNANDEZ DDS
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Gender | Female
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Dates
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Enumeration Date | 10/15/2018
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Last Update Date | 10/15/2018
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Provider Practice Location Address
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Address Line | 10300 SW 216TH ST
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City | CUTLER BAY
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State | FL
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Zip | 33190-1003
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Country | US
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Telephone | 786-293-5502
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Fax |
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Provider Business Mailing Address
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Address Line | 5400 SW 77TH CT APT 2H
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City | MIAMI
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State | FL
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Zip | 33155-4328
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Country | US
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Telephone | 786-879-2381
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DN23756
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License Number State | FL
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