Healthcare Provider Details

I. General information

NPI: 1689592412
Provider Name (Legal Business Name): STEPHANIE ANDREINA MORENO FLORES DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/08/2026
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1420 NW NORTH RIVER DR STE 170
MIAMI FL
33125-2891
US

IV. Provider business mailing address

1420 NW NORTH RIVER DR STE 170
MIAMI FL
33125-2891
US

V. Phone/Fax

Practice location:
  • Phone: 305-702-1807
  • Fax:
Mailing address:
  • Phone: 305-702-1807
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDN32251
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: