Healthcare Provider Details

I. General information

NPI: 1194562876
Provider Name (Legal Business Name): FLOSS DENTAL GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/10/2024
Last Update Date: 07/10/2024
Certification Date: 07/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15600 NW 67TH AVE STE 106
MIAMI LAKES FL
33014-2175
US

IV. Provider business mailing address

15600 NW 67TH AVE STE 106
MIAMI LAKES FL
33014-2175
US

V. Phone/Fax

Practice location:
  • Phone: 786-709-5006
  • Fax:
Mailing address:
  • Phone: 786-709-5006
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223D0001X
TaxonomyPublic Health Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. JULIO C LIMA JR.
Title or Position: PRESIDENT
Credential: DDS
Phone: 786-709-5006