MEDICARE: MIRO KENDALL OFFICE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	DN11650	FL

General Provider Information

NPI Number	:	1033427158
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MIRO KENDALL OFFICE

Provider Business Mailing Address
First Line	:	11916 SW 88TH ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33186-2010
Country	:	US
Telephone Number	:	305-273-4334
Fax Number	:

Provider Business Practice Location Address
First Line	:	11916 SW 88TH ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33186-2010
Country	:	US
Telephone Number	:	305-273-4334
Fax Number	:

Authorized Official
Title or Position	:	DOCTOR
Name	:	DR. CLAUDIO L MIRO
Credential	:	DDS
Telephone Number	:	305-273-4334

Provider Enumeration Date	:	09/23/2010
Last Update Date	:	09/23/2010

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Directions to “MIRO KENDALL OFFICE ” Practice Location

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