Provider Demographics
NPI:1922133099
Name:GONZALEZ-FUJARA, MARIA (DDS)
Entity Type:Individual
Prefix:DR
First Name:MARIA
Middle Name:
Last Name:GONZALEZ-FUJARA
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 1:5333 COLLINS AVE
Mailing Address - Street 2:# 1211
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33140-2567
Mailing Address - Country:US
Mailing Address - Phone:305-979-7006
Mailing Address - Fax:
Practice Address - Street 1:625 SE 2ND AVE STE D
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33435-5065
Practice Address - Country:US
Practice Address - Phone:561-739-3222
Practice Address - Fax:561-336-3532
Is Sole Proprietor?:No
Enumeration Date:2007-02-22
Last Update Date:2014-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN148571223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice