MEDICARE: GATEWAY DENTAL INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry

General Provider Information

NPI Number	:	1184925653
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GATEWAY DENTAL INC

Provider Business Mailing Address
First Line	:	2375 SW 27TH AVE
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33145-3641
Country	:	US
Telephone Number	:	305-856-2300
Fax Number	:	305-856-0921

Provider Business Practice Location Address
First Line	:	2375 SW 27TH AVE
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33145-3641
Country	:	US
Telephone Number	:	305-856-2300
Fax Number	:	305-856-0921

Authorized Official
Title or Position	:	DENTIST
Name	:	DR. PABLO MIRANDA
Credential	:
Telephone Number	:	305-856-2300

Provider Enumeration Date	:	11/15/2010
Last Update Date	:	04/21/2026

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Directions to “GATEWAY DENTAL INC ” Practice Location

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