Healthcare Provider Details

I. General information

NPI: 1407643232
Provider Name (Legal Business Name): YANET GUZMAN RODRIGUEZ DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/23/2025
Last Update Date: 08/24/2025
Certification Date: 08/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5380 DONALD ROSS RD STE 100
PALM BEACH GARDENS FL
33418-7282
US

IV. Provider business mailing address

115 VIA VERACRUZ
JUPITER FL
33458-6912
US

V. Phone/Fax

Practice location:
  • Phone: 561-323-7117
  • Fax:
Mailing address:
  • Phone: 561-713-4279
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDN30150
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: