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General NPI Number Information
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NPI Number | 1316403140
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Entity Type | Individual
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Provider Name | EILYN RIVERO SANES
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Gender | Female
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Dates
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Enumeration Date | 02/18/2019
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Last Update Date | 02/28/2024
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Provider Practice Location Address
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Address Line | 5551 N UNIVERSITY DR STE 203
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City | CORAL SPRINGS
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State | FL
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Zip | 33067-4651
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Country | US
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Telephone | 954-361-0464
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Fax |
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Provider Business Mailing Address
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Address Line | 4333 MAGNOLIA RIDGE DR
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City | WESTON
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State | FL
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Zip | 33331-5000
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Country | US
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Telephone | 772-777-0732
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Fax |
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DN25915
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License Number State | FL
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