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General NPI Number Information
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NPI Number | 1659721900
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Entity Type | Individual
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Provider Name | MARIO ONATE
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Gender | Male
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Dates
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Enumeration Date | 06/17/2016
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Last Update Date | 09/10/2019
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Provider Practice Location Address
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Address Line | 149 W 21ST ST
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City | HIALEAH
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State | FL
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Zip | 33010-2615
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Country | US
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Telephone | 305-775-6486
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Fax |
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Provider Business Mailing Address
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Address Line | 611 NW 82ND AVE APT 314
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City | MIAMI
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State | FL
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Zip | 33126-6903
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Country | US
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Telephone | 305-775-6486
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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 | 23668
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License Number State | FL
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