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General NPI Number Information
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NPI Number | 1740651512
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Entity Type | Organization
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Legal Business Name | DR LIDIA M PAZ DOS PA
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Dates
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Enumeration Date | 10/19/2015
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Last Update Date | 10/19/2015
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Provider Practice Location Address
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Address Line | 950 N KROME AVE SUITE # 207
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City | HOMESTEAD
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State | FL
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Zip | 33030-4400
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Country | US
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Telephone | 305-247-5264
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Fax | 305-247-8361
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Provider Business Mailing Address
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Address Line | 950 N KROME AVE SUITE # 207
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City | HOMESTEAD
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State | FL
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Zip | 33030-4400
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Country | US
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Telephone | 305-247-5264
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Fax | 305-247-8361
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Authorized Official
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Title or Position | DENTIST
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Name | DR. LIDIA M PAZ
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Credential | DDS
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Telephone | 305-247-5264
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BC3200X
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Taxonomy Name | Customized Equipment (DME)
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License Number |
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License Number State |
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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 | 17927
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License Number State | FL
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