Healthcare Provider Details

I. General information

NPI: 1679663397
Provider Name (Legal Business Name): ERIKA PAOLA TUGENDHAT DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/13/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1261 SW 8TH ST
MIAMI FL
33135-4003
US

IV. Provider business mailing address

636 MAJORCA AVE
CORAL GABLES FL
33134-3753
US

V. Phone/Fax

Practice location:
  • Phone: 305-858-2545
  • Fax: 305-858-2545
Mailing address:
  • Phone: 305-442-2915
  • Fax: 305-442-2915

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License NumberDN16864
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: