Provider Demographics
NPI:1588406441
Name:ZAIDA FERNANDEZ, JUAN GILBERTO (DMD)
Entity type:Individual
Prefix:
First Name:JUAN
Middle Name:GILBERTO
Last Name:ZAIDA FERNANDEZ
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2726 4TH ST W
Mailing Address - Street 2:
Mailing Address - City:LEHIGH ACRES
Mailing Address - State:FL
Mailing Address - Zip Code:33971-1938
Mailing Address - Country:US
Mailing Address - Phone:407-536-1893
Mailing Address - Fax:
Practice Address - Street 1:2726 4TH ST W
Practice Address - Street 2:
Practice Address - City:LEHIGH ACRES
Practice Address - State:FL
Practice Address - Zip Code:33971-1938
Practice Address - Country:US
Practice Address - Phone:407-536-1893
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-11
Last Update Date:2024-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL29136122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist