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General NPI Number Information
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NPI Number | 1487269916
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Entity Type | Individual
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Provider Name | SYREN GONZALEZ PEREZ DMD
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Gender | Female
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Dates
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Enumeration Date | 09/11/2020
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Last Update Date | 06/03/2021
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Provider Practice Location Address
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Address Line | 6936 LONG PINE CIR
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City | COCONUT CREEK
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State | FL
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Zip | 33073-3079
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Country | US
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Telephone | 305-956-8346
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Fax |
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Provider Business Mailing Address
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Address Line | 6936 LONG PINE CIR
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City | COCONUT CREEK
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State | FL
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Zip | 33073-3079
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Country | US
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Telephone | 305-956-8346
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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 | 22DIO2812100
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DN25096
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 22DI02812100
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License Number State | NJ
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