Provider Demographics
NPI:1669841565
Name:FERNANDEZ, ZULEIDY (DMD)
Entity Type:Individual
Prefix:DR
First Name:ZULEIDY
Middle Name:
Last Name:FERNANDEZ
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:DR
Other - First Name:ZULY
Other - Middle Name:
Other - Last Name:FERNANDEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DMD
Mailing Address - Street 1:200 1ST ST SW
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MN
Mailing Address - Zip Code:55905-0001
Mailing Address - Country:US
Mailing Address - Phone:305-910-5503
Mailing Address - Fax:
Practice Address - Street 1:290 ALHAMBRA CIR
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-5143
Practice Address - Country:US
Practice Address - Phone:305-239-8806
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-21
Last Update Date:2019-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR003197122300000X
MND136351223S0112X
FLDN243851223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics
No122300000XDental ProvidersDentist
No1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery