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General NPI Number Information
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NPI Number | 1487342382
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Entity Type | Individual
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Provider Name | ISABELA SOUZA
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Gender | Female
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Dates
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Enumeration Date | 04/27/2023
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Last Update Date | 03/07/2025
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Provider Practice Location Address
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Address Line | 9960 PINES BLVD STE 103
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City | PEMBROKE PINES
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State | FL
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Zip | 33024-6139
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Country | US
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Telephone | 754-331-9773
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Fax |
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Provider Business Mailing Address
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Address Line | 9960 PINES BLVD STE 103
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City | PEMBROKE PINES
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State | FL
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Zip | 33024-6139
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Country | US
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Telephone | 929-515-4335
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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 | DN29527
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License Number State | FL
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