MEDICARE: DR. MARIANGEL FERNANDEZ-MARTINEZ D.M.D

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	DN19079	FL
2	1223G0001X	General Practice Dentistry	DN 19079	FL

General Provider Information

NPI Number	:	1376857441
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARIANGEL FERNANDEZ-MARTINEZ D.M.D

Provider Business Mailing Address
First Line	:	8665 VIA ANCHO RD
Second Line	:
City	:	BOCA RATON
State	:	FL
Zip	:	33433-2227
Country	:	US
Telephone Number	:	352-727-8547
Fax Number	:

Provider Business Practice Location Address
First Line	:	8903 GLADES RD STE A7
Second Line	:
City	:	BOCA RATON
State	:	FL
Zip	:	33434-4023
Country	:	US
Telephone Number	:	352-727-8547
Fax Number	:

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

Provider Enumeration Date	:	08/01/2010
Last Update Date	:	02/10/2020

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Directions to “ DR. MARIANGEL FERNANDEZ-MARTINEZ D.M.D” Practice Location

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