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General NPI Number Information
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NPI Number | 1336827542
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Entity Type | Individual
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Provider Name | EDISNEL CARRAZANA GARCES DDS
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Gender | Male
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Dates
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Enumeration Date | 07/07/2023
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Last Update Date | 07/07/2023
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Provider Practice Location Address
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Address Line | 2706 N UNIVERSITY DR
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City | SUNRISE
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State | FL
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Zip | 33322-2435
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Country | US
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Telephone | 954-741-0700
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Fax |
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Provider Business Mailing Address
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Address Line | 10850 W FLAGLER ST APT D308
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City | MIAMI
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State | FL
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Zip | 33174-1463
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Country | US
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Telephone | 813-573-4921
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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 | DN28344
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License Number State | FL
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