Individual
DR. RUI PAULO FERNANDES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D. , D.M.D.
Contact information
Practice address
655 W 8TH ST, UFJP ORAL MAXILLOFACIAL SURGERY, JACKSONVILLE, FL 32209-6511
(904) 244-3216
(904) 244-3218
Mailing address
PO BOX 44008, UFJP PROVIDER ENROLLMENT, JACKSONVILLE, FL 32231-4008
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
DTP453
FL
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
D0004920
AL
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
DN123287
GA
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
ME93053
FL
208600000X
Surgery Physician
ME93053
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0760986-00
—
FL
05
—
2723425-00
—
FL
05
—
846801174A
—
GA
Enumeration date
02/21/2006
Last updated
01/11/2024
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