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General NPI Number Information
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NPI Number | 1174342596
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Entity Type | Organization
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Legal Business Name | ZINNIA SOTOLONGO DMD PA
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Dates
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Enumeration Date | 10/03/2024
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Last Update Date | 10/03/2024
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Provider Practice Location Address
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Address Line | 13005 SOUTHERN BLVD STE 114
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City | LOXAHATCHEE
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State | FL
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Zip | 33470-9231
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Country | US
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Telephone | 561-793-4477
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Fax |
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Provider Business Mailing Address
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Address Line | 160 FORESTER CT
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City | WELLINGTON
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State | FL
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Zip | 33414-4002
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Country | US
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Telephone | 786-973-1940
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Fax |
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Authorized Official
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Title or Position | DENTIST
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Name | ZINNIA SOTOLONGO
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Credential | DMD
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Telephone | 786-973-1940
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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