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General NPI Number Information
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NPI Number | 1033639554
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Entity Type | Individual
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Provider Name | LEYDY TORIBIO FABELO DMD
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Gender | Female
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Dates
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Enumeration Date | 06/26/2017
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Last Update Date | 06/26/2017
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Provider Practice Location Address
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Address Line | 10457 SW 40TH ST
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City | MIAMI
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State | FL
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Zip | 33165-3753
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Country | US
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Telephone | 305-747-7253
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Fax |
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Provider Business Mailing Address
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Address Line | 2758 W 73RD PL
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City | HIALEAH
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State | FL
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Zip | 33016-5423
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Country | US
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Telephone | 786-663-5575
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 22695
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License Number State | FL
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