Healthcare Provider Details

I. General information

NPI: 1255265583
Provider Name (Legal Business Name): PATRICIA FORTE DIAZ ARGUELLES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/11/2026
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2879 S UNIVERSITY DR
DAVIE FL
33328-1440
US

IV. Provider business mailing address

300 BAYVIEW DR APT 716
SUNNY ISLES BEACH FL
33160-4745
US

V. Phone/Fax

Practice location:
  • Phone: 954-890-2879
  • Fax:
Mailing address:
  • Phone: 786-483-4207
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDN31825
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: