Healthcare Provider Details

I. General information

NPI: 1154490373
Provider Name (Legal Business Name): ANIA CABRERIZO D.M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/06/2006
Last Update Date: 05/09/2024
Certification Date: 05/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13757 SW 152ND ST
MIAMI FL
33177-8125
US

IV. Provider business mailing address

13757 SW 152ND ST
MIAMI FL
33177-8125
US

V. Phone/Fax

Practice location:
  • Phone: 305-251-5390
  • Fax:
Mailing address:
  • Phone: 305-251-5390
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License NumberDN16674
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: