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General NPI Number Information
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NPI Number | 1376773895
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Entity Type | Individual
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Provider Name | DANAE VITAL D.D.S.
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Gender | Female
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Dates
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Enumeration Date | 07/17/2009
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Last Update Date | 04/28/2022
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Provider Practice Location Address
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Address Line | 1250 SW 27TH AVE STE 206
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City | MIAMI
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State | FL
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Zip | 33135-4748
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Country | US
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Telephone | 305-649-2231
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Fax | 305-541-0253
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Provider Business Mailing Address
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Address Line | 8910 NW 162ND TER
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City | HIALEAH
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State | FL
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Zip | 33018-6108
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Country | US
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Telephone | 305-819-7398
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | DN18585
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License Number State | FL
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