Individual provider Active NPI

Rocio De Los Angeles Tuero Perez

  • Dentist
  • Miramar, FL
National Provider Identifier
1225872799
Registry record updated Jun 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN29104 Issued in FL
Practice address
12621 Miramar Pkwy Bay 102
Miramar, FL 33027-2910
Phone
(954) 621-1496
NPI assigned
Jun 20, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN29104 FL Primary

Addresses

Primary practice location

12621 Miramar Pkwy Bay 102
Miramar, FL 33027-2910

Mailing address

1510 SW 149TH Ave
Miami, FL 33194-2520
Phone (786) 765-7176

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240926000566 FL Order and Referring Only - DentistPractitioner - Dentist 6800337130

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN29104FLMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Miramar Modern Dentistry, PA CurrentSince Jun 23, 2024 Accepting new patients

Locations

12621 Miramar Pkwy
#102
Miramar, FL 33027
Phone (954) 621-1496

Networks

  • Freedom Health HMO Network

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1718841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718841600000",
    "number": "1225872799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1510 SW 149TH AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331942520",
            "telephone_number": "786-765-7176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12621 MIRAMAR PKWY BAY 102",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "330272910",
            "telephone_number": "954-621-1496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUERO PEREZ",
        "first_name": "ROCIO",
        "middle_name": "DE LOS ANGELES",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-20",
        "last_updated": "2024-06-20",
        "certification_date": "2024-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN29104",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miramar, FL

Sources for this page

Verify at the official NPI Registry.