Healthcare Provider Details

I. General information

NPI: 1396850947
Provider Name (Legal Business Name): NESTOR LEOPOLDO ARAUZ SR. DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/21/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8410 W FLAGLER ST #104
MIAMI FL
33144
US

IV. Provider business mailing address

8410 W FLAGLER ST #104
MIAMI FL
33144
US

V. Phone/Fax

Practice location:
  • Phone: 305-229-7026
  • Fax: 305-264-8069
Mailing address:
  • Phone: 305-229-7026
  • Fax: 305-264-8069

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License NumberDN0012648
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: