Healthcare Provider Details

I. General information

NPI: 1437747367
Provider Name (Legal Business Name): DNS OF FLORIDA IIII, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/06/2021
Last Update Date: 01/06/2021
Certification Date: 01/06/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8323 NW 12TH ST STE 216
DORAL FL
33126-1840
US

IV. Provider business mailing address

8323 NW 12TH ST STE 216
DORAL FL
33126-1840
US

V. Phone/Fax

Practice location:
  • Phone: 305-284-7484
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code246Z00000X
TaxonomyOther Specialist/Technologist
License Number
License Number State

VIII. Authorized Official

Name: DR. JOSE PELAYO
Title or Position: PRESIDENT
Credential:
Phone: 305-287-7484