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General NPI Number Information
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NPI Number | 1023296753
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Entity Type | Organization
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Legal Business Name | DR. JOEL E. VACCAREZZA DDS PA
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Dates
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Enumeration Date | 02/05/2008
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Last Update Date | 02/05/2008
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Provider Practice Location Address
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Address Line | 9999 NE 2ND AVE STE 308
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City | MIAMI SHORES
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State | FL
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Zip | 33138-2346
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Country | US
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Telephone | 305-757-6991
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Fax | 305-757-0042
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Provider Business Mailing Address
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Address Line | 9999 NE 2ND AVE STE 308
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City | MIAMI SHORES
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State | FL
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Zip | 33138-2346
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Country | US
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Telephone | 305-757-6991
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Fax | 305-757-0042
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Authorized Official
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Title or Position | OWNER
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Name | DR. JOEL E VACCAREZZA
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Credential | DDS
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Telephone | 305-757-6991
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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