Ambiance Surgical Arts Center | |
8501 Sw 124th Ave Ste 208 Miami FL 33183-4633 | |
(786) 377-4344 | |
(786) 377-4364 |
Full Name | Ambiance Surgical Arts Center |
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Speciality | Dentist |
Location | 8501 Sw 124th Ave Ste 208, Miami, Florida |
Authorized Official Name and Position | Jerri D Hines (OWNER) |
Authorized Official Contact | 7863774344 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Ambiance Surgical Arts Center 8501 Sw 124th Ave Ste 208 Miami FL 33183-4633 Ph: (786) 377-4344 | Ambiance Surgical Arts Center 8501 Sw 124th Ave Ste 208 Miami FL 33183-4633 Ph: (786) 377-4344 |
NPI Number | 1437703535 |
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Provider Enumeration Date | 07/26/2019 |
Last Update Date | 07/26/2019 |
Medicare PECOS PAC ID | 4486044625 |
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Medicare Enrollment ID | O20211202002034 |
Identifier | Type | State | Issuer |
---|---|---|---|
1437703535 | NPI | - | NPPES |
TPVP162861-09 | Medicaid | FL |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223S0112X | Dentist - Oral And Maxillofacial Surgery | (* (Not Available)) | Primary |
Provider Name | Jerri D Hines |
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Provider Type | Practitioner - Maxillofacial Surgery |
Provider Identifiers | NPI Number: 1861552770 PECOS PAC ID: 1153600218 Enrollment ID: I20211202002107 |
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