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General NPI Number Information
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NPI Number | 1225773187
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Entity Type | Organization
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Legal Business Name | TATIANA H REINO AGOSTO DDS PA
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Dates
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Enumeration Date | 05/04/2022
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Last Update Date | 05/04/2022
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Provider Practice Location Address
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Address Line | 7235 CORAL WAY STE 203
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City | MIAMI
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State | FL
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Zip | 33155-1451
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Country | US
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Telephone | 786-344-1150
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Fax |
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Provider Business Mailing Address
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Address Line | 7235 CORAL WAY SUITE #203 2651NW 84TH AVE APT 108
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City | DORAL
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State | FL
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Zip | 33122
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Country | US
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Telephone | 786-685-5878
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Fax |
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Authorized Official
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Title or Position | GENERAL DENTIST
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Name | MS. TATIANA H REINO AGOSTO
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Credential | DDS
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Telephone | 786-685-5878
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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