MEDICARE: MISS VALERIE MARIE FERNANDEZ 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	122300000X	Dentist	30159	FL
2	122300000X	Dentist	06432201	NY

General Provider Information

NPI Number	:	1508554064
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS VALERIE MARIE FERNANDEZ DDS

Provider Business Mailing Address
First Line	:	7983 NW 161ST TER
Second Line	:
City	:	MIAMI LAKES
State	:	FL
Zip	:	33016-6657
Country	:	US
Telephone Number	:	305-764-6549
Fax Number	:

Provider Business Practice Location Address
First Line	:	499 WILLIAM FLOYD PKWY
Second Line	:
City	:	SHIRLEY
State	:	NY
Zip	:	11967-3416
Country	:	US
Telephone Number	:	631-281-1440
Fax Number	:

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

Provider Enumeration Date	:	04/24/2023
Last Update Date	:	06/19/2025

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