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General NPI Number Information
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NPI Number | 1902474901
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Entity Type | Individual
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Provider Name | BEATRIZ RAVELO DMD
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Gender | Female
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Dates
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Enumeration Date | 06/15/2021
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Last Update Date | 01/17/2023
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Provider Practice Location Address
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Address Line | 3027 W 16TH AVE
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City | HIALEAH
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State | FL
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Zip | 33012-4607
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Country | US
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Telephone | 786-660-1547
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Fax |
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Provider Business Mailing Address
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Address Line | 3027 W 16TH AVE
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City | HIALEAH
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State | FL
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Zip | 33012-4607
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Country | US
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Telephone | 786-660-1547
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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 | DN25941
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License Number State | FL
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