Provider Demographics
NPI:1962008201
Name:FISCHER, CECILIA AUZA (RDH)
Entity Type:Individual
Prefix:MRS
First Name:CECILIA
Middle Name:AUZA
Last Name:FISCHER
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23036 STATE ROAD 54 # 403
Mailing Address - Street 2:
Mailing Address - City:LUTZ
Mailing Address - State:FL
Mailing Address - Zip Code:33549-6968
Mailing Address - Country:US
Mailing Address - Phone:813-909-1317
Mailing Address - Fax:
Practice Address - Street 1:34806 ASHCREST WAY
Practice Address - Street 2:
Practice Address - City:ZEPHYRHILLS
Practice Address - State:FL
Practice Address - Zip Code:33541-2104
Practice Address - Country:US
Practice Address - Phone:813-482-8853
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-10
Last Update Date:2020-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDH21173124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist