Healthcare Provider Details

I. General information

NPI: 1316413719
Provider Name (Legal Business Name): ANABEL MIRALLES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/23/2018
Last Update Date: 08/21/2026
Certification Date: 08/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7031 SW 62ND AVE
SOUTH MIAMI FL
33143-4701
US

IV. Provider business mailing address

14928 SW 40TH ST
MIAMI FL
33185-4279
US

V. Phone/Fax

Practice location:
  • Phone: 305-284-7761
  • Fax: 305-284-7787
Mailing address:
  • Phone: 786-234-1587
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDN32250
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: