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General NPI Number Information
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NPI Number | 1124682299
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Entity Type | Organization
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Legal Business Name | PICASSO DENTAL MIAMI, INC
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Dates
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Enumeration Date | 04/24/2019
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Last Update Date | 05/13/2019
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Provider Practice Location Address
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Address Line | 9230 SW 40TH ST STE A
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City | MIAMI
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State | FL
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Zip | 33165
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Country | US
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Telephone | 305-221-2334
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Fax | 305-221-2335
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Provider Business Mailing Address
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Address Line | 9230 SW 40TH ST STE A
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City | MIAMI
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State | FL
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Zip | 33165
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Country | US
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Telephone | 305-221-2334
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Fax | 305-221-2335
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Authorized Official
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Title or Position | DENTIST/OWNER
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Name | RAIKO ROJAS
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Credential | DMD
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Telephone | 305-388-9229
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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