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General NPI Number Information
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NPI Number | 1245529072
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Entity Type | Individual
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Provider Name | TRACY CABEZAS
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Gender | Female
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Dates
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Enumeration Date | 04/01/2011
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Last Update Date | 04/01/2011
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Provider Practice Location Address
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Address Line | 7600 RED RD SUITE 101
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City | SOUTH MIAMI
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State | FL
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Zip | 33143-5428
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Country | US
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Telephone | 305-661-5297
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Fax | 305-667-3503
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Provider Business Mailing Address
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Address Line | 7600 RED RD SUITE 101
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City | SOUTH MIAMI
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State | FL
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Zip | 33143-5428
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Country | US
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Telephone | 305-661-5297
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Fax | 305-667-3503
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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 | 126800000X
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Taxonomy Name | Dental Assistant
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License Number |
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License Number State |
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