Healthcare Provider Details

I. General information

NPI: 1114848330
Provider Name (Legal Business Name): MARTA ELENA BRITO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/23/2026
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4629 SW 143RD CT
MIAMI FL
33175-6859
US

IV. Provider business mailing address

4629 SW 143RD CT
MIAMI FL
33175-6859
US

V. Phone/Fax

Practice location:
  • Phone: 786-599-3663
  • Fax:
Mailing address:
  • Phone: 786-599-3663
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDN32326
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: