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General NPI Number Information
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NPI Number | 1801588090
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Entity Type | Individual
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Provider Name | CARLOS YANES GONZALEZ DMD
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Gender | Male
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Dates
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Enumeration Date | 05/24/2023
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Last Update Date | 08/05/2025
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Provider Practice Location Address
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Address Line | 1625 E LAS OLAS BLVD
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City | FORT LAUDERDALE
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State | FL
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Zip | 33301-2357
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Country | US
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Telephone | 954-463-5051
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Fax |
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Provider Business Mailing Address
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Address Line | 3890 SW 64TH AVE APT 358
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City | DAVIE
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State | FL
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Zip | 33314-2587
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Country | US
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Telephone | 786-619-5587
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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 | 27921
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License Number State | FL
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