Healthcare Provider Details

I. General information

NPI: 1295114684
Provider Name (Legal Business Name): YAMILIA MOREJON D.D.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/19/2015
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5232 W FLAGLER ST
CORAL GABLES FL
33134-1168
US

IV. Provider business mailing address

5232 W FLAGLER ST
CORAL GABLES FL
33134-1168
US

V. Phone/Fax

Practice location:
  • Phone: 305-442-0331
  • Fax: 305-442-0664
Mailing address:
  • Phone: 305-442-0331
  • Fax: 305-442-0664

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDN22893
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: