Provider Demographics
NPI:1437647567
Name:DANTAS FERREIRA FERNANDES, AMANDA (MD)
Entity Type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:
Last Name:DANTAS FERREIRA FERNANDES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MS
Other - First Name:AMANDA
Other - Middle Name:
Other - Last Name:DANTAS CAVALCANTE FERREIRA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:1611 NW 12TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33136
Mailing Address - Country:US
Mailing Address - Phone:786-773-7313
Mailing Address - Fax:
Practice Address - Street 1:840 HARRISON AVE
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02118-2905
Practice Address - Country:US
Practice Address - Phone:617-638-8000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-24
Last Update Date:2021-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program