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4005 Sw 152nd Ave Miami FL 33185-5919 | |
| (786) 409-5295 | |
| (786) 703-7908 |
| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 4005 Sw 152nd Ave, Miami, Florida |
| Authorized Official Name and Position | Farah Aymee Diaz (PRESIDENT) |
| Authorized Official Contact | 7866195393 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
4005 Sw 152nd Ave Miami FL 33185-5919 Ph: (786) 409-5295 | 4005 Sw 152nd Ave Miami FL 33185-5919 Ph: (786) 409-5295 |
| NPI Number | 1407217813 |
|---|---|
| Provider Enumeration Date | 03/11/2016 |
| Last Update Date | 03/11/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407217813 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | DN20362 (Florida) | Primary |
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