Provider Demographics
NPI:1366060048
Name:FERNANDEZ-CORDERO, ANA ELVY (DMD)
Entity type:Individual
Prefix:
First Name:ANA
Middle Name:ELVY
Last Name:FERNANDEZ-CORDERO
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16300 SW 51ST ST
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33027-4965
Mailing Address - Country:US
Mailing Address - Phone:786-553-8197
Mailing Address - Fax:
Practice Address - Street 1:16300 SW 51ST ST
Practice Address - Street 2:
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33027-4965
Practice Address - Country:US
Practice Address - Phone:786-553-8197
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-09
Last Update Date:2020-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL25178122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist