Healthcare Provider Details

I. General information

NPI: 1437204765
Provider Name (Legal Business Name): GISLEDA ANNETTE RAMOS D.D.S,M.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/25/2007
Last Update Date: 11/10/2021
Certification Date: 11/10/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7663 W SAMPLE RD
CORAL SPRINGS FL
33065-4718
US

IV. Provider business mailing address

7663 W SAMPLE RD
CORAL SPRINGS FL
33065-4718
US

V. Phone/Fax

Practice location:
  • Phone: 954-775-0723
  • Fax: 754-241-0242
Mailing address:
  • Phone: 772-692-3900
  • Fax: 754-241-0242

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License NumberDN13470
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: