Healthcare Provider Details

I. General information

NPI: 1760702575
Provider Name (Legal Business Name): VIRGINIA DEL C. BATISTA D.D.S
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/03/2010
Last Update Date: 06/03/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11498 QUAIL ROOST DR
MIAMI FL
33157-6575
US

IV. Provider business mailing address

41 NE 165TH ST
MIAMI FL
33162-3435
US

V. Phone/Fax

Practice location:
  • Phone: 305-232-4469
  • Fax: 305-232-4487
Mailing address:
  • Phone: 786-389-9005
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDN18983
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: