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General NPI Number Information
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NPI Number | 1942030150
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Entity Type | Individual
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Provider Name | MIRNA FABIOLA LAMAS DENTAL HYGIENIST
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Gender | Female
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Dates
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Enumeration Date | 08/02/2024
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Last Update Date | 08/02/2024
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Provider Practice Location Address
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Address Line | 450 TURNER ST
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City | PENSACOLA
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State | FL
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Zip | 32508-5211
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Country | US
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Telephone | 850-452-5600
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Fax |
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Provider Business Mailing Address
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Address Line | 282 S 61ST AVE
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City | PENSACOLA
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State | FL
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Zip | 32506-7619
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Country | US
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Telephone | 757-831-4353
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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 | 124Q00000X
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Taxonomy Name | Dental Hygienist
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License Number | DH28680
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License Number State | FL
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