Healthcare Provider Details

I. General information

NPI: 1144783259
Provider Name (Legal Business Name): YAMEL MAQUEIRA DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/08/2019
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5600 WATERFORD DISTRICT DR STE 15
MIAMI FL
33126-2370
US

IV. Provider business mailing address

2141 SW 149TH PASS
MIAMI FL
33185-5784
US

V. Phone/Fax

Practice location:
  • Phone: 786-876-5600
  • Fax: 786-687-5601
Mailing address:
  • Phone: 407-978-9452
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number26268
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: