Healthcare Provider Details

I. General information

NPI: 1811821663
Provider Name (Legal Business Name): CORSAR DENTAL II, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/09/2026
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4011 W FLAGLER ST STE 201
CORAL GABLES FL
33134-1643
US

IV. Provider business mailing address

5800 SW 22ND ST
MIAMI FL
33155-2227
US

V. Phone/Fax

Practice location:
  • Phone: 305-649-4242
  • Fax:
Mailing address:
  • Phone: 786-303-6741
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: YOAN CORTIZA SARDINAS
Title or Position: GENERAL DENTIST
Credential:
Phone: 786-303-6741