South Miami Dental Service PA
Organization Active NPI Health Maintenance Organization · Key Biscayne, FL
NPI 1104274471 · NPPES record last updated May 27, 2016
Key facts
- NPI
- 1104274471
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Health Maintenance Organization 302R00000X
- License
- DN18909 (FL)
- Legal business name
- SOUTH MIAMI DENTAL SERVICE PA
- Practice address
- 240 Crandon Blvd
Suite 104
Key Biscayne, FL 33149 - Phone
- (305) 361-0351
- Fax
- (305) 361-2180
- NPI assigned
- May 27, 2016
- Organization subpart
- No
Authorized official
- Name
- Mayra V Perez
- Title
- Admnistrator
- Phone
- (305) 361-5493
Corporate family (same tax ID) 1
Practitioners 2
-
Jose Luis Chaviano Jr., D.M.D
-
Alberto Suarez, D.D.S.
National Provider Directory
- Tax ID family
- Illustradent Key Biscayne
Locations
240 Crandon Blvd
Ste 104
Key Biscayne, FL 33149
Phone (305) 361-0351
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Health Maintenance Organization | 302R00000X | DN18909 | FL | Yes |
Addresses
Primary practice location
240 Crandon Blvd
Suite 104
Key Biscayne, FL 33149
Mailing address
240 Crandon Blvd
Suite 104
Key Biscayne, FL 33149
Phone (305) 661-5360
Other names
- Illustradent key biscayne
Other providers in Key Biscayne, FL
- Patricia Lauren Prins Rodriguez
- Roland Gracia PA
- Lidia Rubio
- David Serra
- Victoria Anne Simons
- Alberto Suarez
- Susana Leal-Khouri, Mdpa
- Total Care Therapy Services Inc
- Total Functional Rehabilitation Therapy,
- Karla Umpierre
All providers in Key Biscayne, FL · Health Maintenance Organization in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 27, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.