Healthcare Provider Details

I. General information

NPI: 1811166838
Provider Name (Legal Business Name): CARLOS PRIA D.M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/23/2008
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3601 FEDERAL HWY
MIAMI FL
33137-3795
US

IV. Provider business mailing address

3601 FEDERAL HWY
MIAMI FL
33137-3795
US

V. Phone/Fax

Practice location:
  • Phone: 305-576-6611
  • Fax: 786-476-2818
Mailing address:
  • Phone: 305-576-6611
  • Fax: 786-476-2819

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDN19549
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License Number19249
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: