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General NPI Number Information
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NPI Number | 1952194219
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Entity Type | Individual
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Provider Name | JORGE LUIS CASANAS MARRERO DMD
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Gender | Male
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Dates
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Enumeration Date | 05/28/2025
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Last Update Date | 05/28/2025
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Provider Practice Location Address
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Address Line | 747 PONCE DE LEON BLVD STE 401
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City | CORAL GABLES
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State | FL
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Zip | 33134-2073
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Country | US
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Telephone | 786-227-0873
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Fax |
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Provider Business Mailing Address
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Address Line | 13105 SW 248TH ST APT 202
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City | HOMESTEAD
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State | FL
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Zip | 33032-6055
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Country | US
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Telephone | 786-227-0873
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 30277
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License Number State | FL
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