Healthcare Provider Details

I. General information

NPI: 1295816924
Provider Name (Legal Business Name): VANESSA ARZOLA DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/18/2006
Last Update Date: 04/28/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13419 SW 56TH ST
MIAMI FL
33175-6117
US

IV. Provider business mailing address

13419 SW 56TH ST
MIAMI FL
33175-6117
US

V. Phone/Fax

Practice location:
  • Phone: 305-559-2663
  • Fax: 305-559-3040
Mailing address:
  • Phone: 305-559-2663
  • Fax: 305-559-3040

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDN15923
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: