Healthcare Provider Details

I. General information

NPI: 1003487349
Provider Name (Legal Business Name): JULIETA MORALES RUEDA DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/08/2021
Last Update Date: 06/18/2024
Certification Date: 06/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9835 SW 72ND ST STE 209
MIAMI FL
33173-4647
US

IV. Provider business mailing address

9835 SW 72ND ST STE 209
MIAMI FL
33173-4647
US

V. Phone/Fax

Practice location:
  • Phone: 305-400-9835
  • Fax: 786-796-9699
Mailing address:
  • Phone: 305-400-9835
  • Fax: 786-796-9699

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDN26331
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: