Healthcare Provider Details

I. General information

NPI: 1447458146
Provider Name (Legal Business Name): JARED PLITT D.M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/05/2007
Last Update Date: 01/08/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 41ST ST SUITE 706
MIAMI BEACH FL
33140-3641
US

IV. Provider business mailing address

333 41ST ST SUITE 706
MIAMI BEACH FL
33140-3641
US

V. Phone/Fax

Practice location:
  • Phone: 305-534-2525
  • Fax: 305-534-7979
Mailing address:
  • Phone: 305-534-2525
  • Fax: 305-534-7979

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDN15729
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: