Healthcare Provider Details

I. General information

NPI: 1407252893
Provider Name (Legal Business Name): OSBEL BORGES DMD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/12/2014
Last Update Date: 11/12/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4308 ALTON RD SUITE 940
MIAMI BEACH FL
33140-4556
US

IV. Provider business mailing address

4308 ALTON RD SUITE 940
MIAMI BEACH FL
33140-4556
US

V. Phone/Fax

Practice location:
  • Phone: 305-604-3216
  • Fax: 305-604-3217
Mailing address:
  • Phone: 305-604-3216
  • Fax: 305-604-3217

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License NumberDN19228
License Number StateFL

VIII. Authorized Official

Name: DR. OSBEL BORGES
Title or Position: OWNER
Credential: DMD
Phone: 305-604-3216