Provider Demographics
NPI:1457628505
Name:BIELAK, PAULA FIUZA (DMD)
Entity Type:Individual
Prefix:DR
First Name:PAULA
Middle Name:FIUZA
Last Name:BIELAK
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2944 TUSCARORA CT
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32904-8098
Mailing Address - Country:US
Mailing Address - Phone:321-890-3425
Mailing Address - Fax:
Practice Address - Street 1:5132 MINTON RD NW STE I
Practice Address - Street 2:
Practice Address - City:PALM BAY
Practice Address - State:FL
Practice Address - Zip Code:32907-1110
Practice Address - Country:US
Practice Address - Phone:321-890-3425
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-17
Last Update Date:2012-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN195351223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice