| Icom Hialeah Llc | |
|
6600 W 12th Ave Hialeah FL 33012-6450 | |
| (305) 846-7987 | |
| (786) 221-4442 |
| Full Name | Icom Hialeah Llc |
|---|---|
| Speciality | Dentist |
| Location | 6600 W 12th Ave, Hialeah, Florida |
| Authorized Official Name and Position | Tatiana Santiago Herzog (DENTIST) |
| Authorized Official Contact | 3054095392 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Icom Hialeah Llc 611 Ne 13th St Ft Lauderdale FL 33304-1109 Ph: (305) 846-7987 | Icom Hialeah Llc 6600 W 12th Ave Hialeah FL 33012-6450 Ph: (305) 846-7987 |
| NPI Number | 1376313130 |
|---|---|
| Provider Enumeration Date | 01/03/2024 |
| Last Update Date | 01/03/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376313130 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
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