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General NPI Number Information
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NPI Number | 1417163742
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Entity Type | Individual
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Provider Name | YANELYS GUERRA GARCIA DMD
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Gender | Female
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Dates
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Enumeration Date | 05/15/2007
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Last Update Date | 03/17/2017
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Provider Practice Location Address
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Address Line | 23280 SW 112TH AVE
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City | HOMESTEAD
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State | FL
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Zip | 33032-7174
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Country | US
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Telephone | 305-321-9782
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Fax |
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Provider Business Mailing Address
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Address Line | 23280 SW 112TH AVE
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City | HOMESTEAD
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State | FL
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Zip | 33032-7174
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Country | US
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Telephone | 305-258-1776
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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 | DN 17131
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License Number State | FL
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