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General NPI Number Information
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NPI Number | 1700228020
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Entity Type | Individual
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Provider Name | PAMELA VANESSA BOSQUE GUEVARA D.D.S
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Gender | Female
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Dates
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Enumeration Date | 07/28/2013
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Last Update Date | 04/15/2020
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Provider Practice Location Address
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Address Line | 1 ALHAMBRA PLZ STE 25
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City | CORAL GABLES
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State | FL
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Zip | 33134-5216
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Country | US
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Telephone | 786-507-4440
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Fax |
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Provider Business Mailing Address
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Address Line | 227 MICHIGAN AVE APT 307
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City | MIAMI BEACH
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State | FL
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Zip | 33139-7082
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Country | US
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Telephone | 860-751-8402
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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 | 21801
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License Number State | FL
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