Provider Demographics
NPI:1699462945
Name:MIJARES OLIVO, MARIA FERNANDA (MD)
Entity type:Individual
Prefix:DR
First Name:MARIA
Middle Name:FERNANDA
Last Name:MIJARES OLIVO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2951 S BAYSHORE DR APT 1017
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33133-6002
Mailing Address - Country:US
Mailing Address - Phone:305-763-2474
Mailing Address - Fax:
Practice Address - Street 1:4225 W 20TH AVE
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-5835
Practice Address - Country:US
Practice Address - Phone:786-828-7552
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-18
Last Update Date:2023-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program