MEDICARE: DR. GERALDINE PALACIOS CARRENO DMD

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	1223G0001X	General Practice Dentistry	DN32013	FL

General Provider Information

NPI Number	:	1053247304
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GERALDINE PALACIOS CARRENO DMD

Provider Business Mailing Address
First Line	:	5396 W 14TH AVE
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33012-3032
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5396 W 14TH AVE
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33012-3032
Country	:	US
Telephone Number	:	786-521-9993
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/23/2026
Last Update Date	:	06/23/2026

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