Healthcare Provider Details

I. General information

NPI: 1841436011
Provider Name (Legal Business Name): ACADIA DENTAL CARE P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/18/2008
Last Update Date: 12/18/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19517 NW 57TH AVE
MIAMI GARDENS FL
33055-4709
US

IV. Provider business mailing address

19517 NW 57TH AVE
MIAMI GARDENS FL
33055-4709
US

V. Phone/Fax

Practice location:
  • Phone: 305-621-3111
  • Fax:
Mailing address:
  • Phone: 305-621-3111
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDN10651
License Number StateFL

VIII. Authorized Official

Name: NIGHAT M SYED
Title or Position: PRESIDENT
Credential: DDS
Phone: 305-621-3111