Provider Demographics
NPI:1720307572
Name:FERNANDEZ-ABRIL, JORGE CARLOS (DDS)
Entity type:Individual
Prefix:DR
First Name:JORGE
Middle Name:CARLOS
Last Name:FERNANDEZ-ABRIL
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7285 SW 90TH ST
Mailing Address - Street 2:UNIT 517
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33156-1656
Mailing Address - Country:US
Mailing Address - Phone:786-395-7136
Mailing Address - Fax:
Practice Address - Street 1:2870 NE 8TH ST
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33033-5695
Practice Address - Country:US
Practice Address - Phone:305-246-5444
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-19
Last Update Date:2010-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN16962122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist