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11865 Sw 26th St Unit G10 Miami FL 33175-2400 | |
| (305) 222-1150 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 11865 Sw 26th St, Miami, Florida |
| Authorized Official Name and Position | Abel O Deanna (PRESIDENT) |
| Authorized Official Contact | 3054442404 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
2901 S Bayshore Dr Apt 4f Miami FL 33133-6016 Ph: (305) 444-2404 | 11865 Sw 26th St Unit G10 Miami FL 33175-2400 Ph: (305) 222-1150 |
| NPI Number | 1194150847 |
|---|---|
| Provider Enumeration Date | 09/12/2013 |
| Last Update Date | 09/12/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194150847 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | DN7784 (Florida) | Primary |
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