Provider Demographics
NPI:1336479518
Name:MANON, AISHA CUADRAS (DMD)
Entity Type:Individual
Prefix:DR
First Name:AISHA
Middle Name:CUADRAS
Last Name:MANON
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:DR
Other - First Name:AISHA
Other - Middle Name:
Other - Last Name:CUADRAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DMD
Mailing Address - Street 1:422 E GORE ST
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32806-1335
Mailing Address - Country:US
Mailing Address - Phone:352-262-7734
Mailing Address - Fax:
Practice Address - Street 1:4098 LIBRA DR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32816-5441
Practice Address - Country:US
Practice Address - Phone:407-823-1635
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-11
Last Update Date:2018-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN180261223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice