Healthcare Provider Details

I. General information

NPI: 1396667820
Provider Name (Legal Business Name): RAFAEL LABORDE RAMOS DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/27/2026
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9301 NAUTILUS DR
CUTLER BAY FL
33189-1828
US

IV. Provider business mailing address

9301 NAUTILUS DR
CUTLER BAY FL
33189-1828
US

V. Phone/Fax

Practice location:
  • Phone: 786-727-7422
  • Fax:
Mailing address:
  • Phone: 786-727-7422
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number32353
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: