Provider Demographics
NPI:1790826683
Name:FERNANDEZ, MARIA CRISTINA (DDS)
Entity Type:Individual
Prefix:DR
First Name:MARIA
Middle Name:CRISTINA
Last Name: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 1:4830 S.W. 8 STREET
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134
Mailing Address - Country:US
Mailing Address - Phone:305-446-1067
Mailing Address - Fax:305-446-0687
Practice Address - Street 1:4830 S.W. 8 STREET
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134
Practice Address - Country:US
Practice Address - Phone:305-446-1067
Practice Address - Fax:305-446-0687
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-12
Last Update Date:2008-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL110691223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL13810OtherORAL HEALTH SERVICE
FL3578OtherCOMP DENT
FL63259OtherBLUE CROSS BLUE SHIELD
FL633142OtherUNITED CONCORDIA
FL23096-1OtherUNITED HEALTH CARE
FL71-11069OtherDELTA
FL9776OtherMET LIFE
FLGD435701OtherPDP
FL0725021-00Medicaid
FL575-3700OtherJMH
FLF4LAOtherTDC