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General NPI Number Information
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NPI Number | 1962501411
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Entity Type | Organization
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Legal Business Name | PERIODONTAL SOLUTIONS OF SOUTH FLORIDA
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Dates
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Enumeration Date | 09/21/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 7600 RED ROAD SUITE 216
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City | SOUTH MIAMI
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State | FL
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Zip | 33143
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Country | US
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Telephone | 305-665-6575
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Fax | 305-661-7076
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Provider Business Mailing Address
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Address Line | 7600 RED ROAD SUITE 216
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City | SOUTH MIAMI
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State | FL
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Zip | 33143
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Country | US
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Telephone | 305-665-6575
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Fax | 305-661-7076
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JORGE L RAMIREZ
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Credential | DMD
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Telephone | 30556656575
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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 | DN0014136
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License Number State | FL
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