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9000 Sw 137th Ave Suite 205 Miami FL 33186-1411 | |
| (305) 386-4663 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 9000 Sw 137th Ave, Miami, Florida |
| Authorized Official Name and Position | Judith Monterrey (PRESIDENT) |
| Authorized Official Contact | 3053864663 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
9000 Sw 137th Ave Suite 205 Miami FL 33186-1411 Ph: (305) 386-4663 | 9000 Sw 137th Ave Suite 205 Miami FL 33186-1411 Ph: (305) 386-4663 |
| NPI Number | 1023401098 |
|---|---|
| Provider Enumeration Date | 03/13/2015 |
| Last Update Date | 03/13/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023401098 | NPI | - | NPPES |
| 013341600 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | DN19838 (Florida) | Primary |
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