Provider Demographics
NPI:1558618132
Name:GARCIA FERNANDEZ, ALIUSKA (DDS)
Entity Type:Individual
Prefix:
First Name:ALIUSKA
Middle Name:
Last Name:GARCIA FERNANDEZ
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6500 COW PEN RD STE 201
Mailing Address - Street 2:
Mailing Address - City:MIAMI LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33014-7620
Mailing Address - Country:US
Mailing Address - Phone:786-226-7461
Mailing Address - Fax:
Practice Address - Street 1:6500 COW PEN RD STE 201
Practice Address - Street 2:
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33014-7620
Practice Address - Country:US
Practice Address - Phone:786-226-7461
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-13
Last Update Date:2014-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN20967122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist