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General NPI Number Information
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NPI Number | 1073720645
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Entity Type | Organization
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Legal Business Name | DENTAL GROUP OF SOUTH FLORIDA,INC
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Dates
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Enumeration Date | 05/16/2007
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Last Update Date | 11/01/2019
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Provider Practice Location Address
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Address Line | 13419 SW 56 ST
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City | MIAMI
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State | FL
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Zip | 33175
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Country | US
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Telephone | 305-559-2663
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Fax | 305-559-3040
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Provider Business Mailing Address
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Address Line | 13419 SW 56 ST
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City | MIAMI
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State | FL
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Zip | 33175
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Country | US
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Telephone | 305-559-2663
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Fax | 305-559-3040
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. MARIA JOSEFINA ALVAREZ
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Credential | DDS
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Telephone | 305-444-8591
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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 | DN11187
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | DN12021
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | DN16376
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License Number State | FL
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Taxonomy #4
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Taxonomy Code | 124Q00000X
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Taxonomy Name | Dental Hygienist
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License Number | DH16946
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License Number State | FL
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Taxonomy #5
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DN17638
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License Number State | FL
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