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General NPI Number Information
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NPI Number | 1710423819
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Entity Type | Individual
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Provider Name | VIVIANNE DE LA CAMARA D.M.D
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Gender | Female
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Dates
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Enumeration Date | 01/12/2017
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Last Update Date | 05/24/2023
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Provider Practice Location Address
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Address Line | 270 WESTWARD DR
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City | MIAMI SPRINGS
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State | FL
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Zip | 33166-5260
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Country | US
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Telephone | 305-381-5669
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Fax | 305-967-8897
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Provider Business Mailing Address
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Address Line | 270 WESTWARD DR
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City | MIAMI SPRINGS
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State | FL
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Zip | 33166-5260
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Country | US
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Telephone | 305-381-5669
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Fax | 305-967-8897
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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 | 15007
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License Number State | FL
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