Provider Demographics
NPI:1184335234
Name:HOELLER DA SILVA, FERNANDA (RDH)
Entity type:Individual
Prefix:
First Name:FERNANDA
Middle Name:
Last Name:HOELLER DA SILVA
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 1:321 EMERALD SHORES CIR APT 101
Mailing Address - Street 2:
Mailing Address - City:OCOEE
Mailing Address - State:FL
Mailing Address - Zip Code:34761-4862
Mailing Address - Country:US
Mailing Address - Phone:858-262-1468
Mailing Address - Fax:
Practice Address - Street 1:3232 W LAKE MARY BLVD
Practice Address - Street 2:
Practice Address - City:LAKE MARY
Practice Address - State:FL
Practice Address - Zip Code:32746-3582
Practice Address - Country:US
Practice Address - Phone:407-323-1010
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-09
Last Update Date:2022-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDH30297124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist