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12251 Taft St Suite 200 Pembroke Pines FL 33026-1901 | |
| (954) 441-8778 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 12251 Taft St, Pembroke Pines, Florida |
| Authorized Official Name and Position | Larry Vinuela (OWNER) |
| Authorized Official Contact | 9544418778 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
12251 Taft St Suite 200 Pembroke Pines FL 33026-1901 Ph: (954) 441-8778 | 12251 Taft St Suite 200 Pembroke Pines FL 33026-1901 Ph: (954) 441-8778 |
| NPI Number | 1346647781 |
|---|---|
| Provider Enumeration Date | 12/01/2014 |
| Last Update Date | 12/01/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346647781 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | DN19253 (Florida) | Primary |
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