Provider Demographics
NPI:1750821609
Name:VILLAFUERTE, ADA CECILIA (DDS)
Entity type:Individual
Prefix:DR
First Name:ADA
Middle Name:CECILIA
Last Name:VILLAFUERTE
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 1:12475 SW 6TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33184-1407
Mailing Address - Country:US
Mailing Address - Phone:305-303-8368
Mailing Address - Fax:
Practice Address - Street 1:590 E 25TH ST
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33013-3841
Practice Address - Country:US
Practice Address - Phone:305-303-8368
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-26
Last Update Date:2024-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN244951223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice