Healthcare Provider Details

I. General information

NPI: 1265518807
Provider Name (Legal Business Name): RITA FIELDS HELLER DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/27/2006
Last Update Date: 12/31/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17301 NW 27TH AVE
OPA LOCKA FL
33056-4001
US

IV. Provider business mailing address

466 SUNSET DR
HALLANDALE BEACH FL
33009-6540
US

V. Phone/Fax

Practice location:
  • Phone: 305-624-1371
  • Fax:
Mailing address:
  • Phone: 305-389-1022
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License NumberDN15288
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: