Healthcare Provider Details

I. General information

NPI: 1497052625
Provider Name (Legal Business Name): SWEET SMILE GROUP INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/24/2011
Last Update Date: 03/06/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5050 NW 7TH ST APT 501
MIAMI FL
33126-3428
US

IV. Provider business mailing address

5050 NW 7TH ST APT 501
MIAMI FL
33126-3428
US

V. Phone/Fax

Practice location:
  • Phone: 786-236-4482
  • Fax: 864-277-0116
Mailing address:
  • Phone: 786-236-4482
  • Fax: 864-277-0116

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number691765896
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code385HR2060X
TaxonomyChild Intellectual and/or Developmental Disabilities Respite Care
License Number691765898
License Number StateFL

VIII. Authorized Official

Name: MRS. MARIA PERERA
Title or Position: PRESIDENT
Credential:
Phone: 786-236-4482