Healthcare Provider Details

I. General information

NPI: 1013786300
Provider Name (Legal Business Name): ELA DENTAL STUDIO, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/27/2023
Last Update Date: 01/31/2024
Certification Date: 01/31/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2525 SW 8TH ST
MIAMI FL
33135-3005
US

IV. Provider business mailing address

3206 NW 89TH TER
CORAL SPRINGS FL
33065-4422
US

V. Phone/Fax

Practice location:
  • Phone: 786-245-6181
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ELEINE LAFFITA
Title or Position: PRESIDENT
Credential: DMD
Phone: 832-296-4098