| Live Implants Corp | |
|
18001 Old Cutler Rd Ste 405 Palmetto Bay FL 33157-6434 | |
| (786) 249-4514 | |
| Not Available |
| Full Name | Live Implants Corp |
|---|---|
| Speciality | Clinic/Center |
| Location | 18001 Old Cutler Rd Ste 405, Palmetto Bay, Florida |
| Authorized Official Name and Position | Virgilio J Mongalo (DOCTOR) |
| Authorized Official Contact | 7862494514 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Live Implants Corp 18001 Old Cutler Rd Ste 405 Palmetto Bay FL 33157-6434 Ph: (786) 249-4514 | Live Implants Corp 18001 Old Cutler Rd Ste 405 Palmetto Bay FL 33157-6434 Ph: (786) 249-4514 |
| NPI Number | 1033780895 |
|---|---|
| Provider Enumeration Date | 07/02/2021 |
| Last Update Date | 07/02/2021 |
| Medicare PECOS PAC ID | 4183013402 |
|---|---|
| Medicare Enrollment ID | O20211108001384 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033780895 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Secondary |
| 261QS0112X | Clinic/center - Oral And Maxillofacial Surgery | (* (Not Available)) | Primary |
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