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General NPI Number Information
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NPI Number | 1851730477
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Entity Type | Individual
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Provider Name | VIVIAN SARA MORAD D.M.D.
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Gender | Female
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Dates
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Enumeration Date | 06/17/2013
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Last Update Date | 11/02/2018
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Provider Practice Location Address
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Address Line | 8950 SW 74TH CT STE 1910
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City | MIAMI
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State | FL
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Zip | 33156-3178
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Country | US
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Telephone | 305-670-3900
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Fax | 305-675-3267
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Provider Business Mailing Address
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Address Line | 8950 SW 74TH CT STE 1910
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City | MIAMI
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State | FL
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Zip | 33156-3178
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Country | US
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Telephone | 305-670-3900
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Fax | 305-675-3267
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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 | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | 12367
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License Number State | FL
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