| Umiami Medicine - Oral Surgery | |
|
1611 Nw 12th Ave Box 016960 M851 Miami FL 33136-1005 | |
| (305) 243-7688 | |
| (305) 243-8470 |
| Full Name | Umiami Medicine - Oral Surgery |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 1611 Nw 12th Ave, Miami, Florida |
| Authorized Official Name and Position | Cesia A Sanchez (MANAGER, PROVIDER ENROLLMENT) |
| Authorized Official Contact | 3052436837 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Umiami Medicine - Oral Surgery 1611 Nw 12th Ave Box 016960 M851 Miami FL 33136-1005 Ph: (305) 243-7688 | Umiami Medicine - Oral Surgery 1611 Nw 12th Ave Box 016960 M851 Miami FL 33136-1005 Ph: (305) 243-7688 |
| NPI Number | 1558312314 |
|---|---|
| Provider Enumeration Date | 05/15/2006 |
| Last Update Date | 04/25/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558312314 | NPI | - | NPPES |
| 0764400-00 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | (* (Not Available)) | Primary |
| 204E00000X | Oral & Maxillofacial Surgery | (* (Not Available)) | Secondary |
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