MEDICARE: DR. PATRICIA C JUNQUERA D.D.S

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	DN10259	FL

General Provider Information

NPI Number	:	1124238712
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PATRICIA C JUNQUERA D.D.S

Provider Business Mailing Address
First Line	:	11890 SW 8TH ST
Second Line	:	SUITE#300
City	:	MIAMI
State	:	FL
Zip	:	33184-1743
Country	:	US
Telephone Number	:	305-551-8200
Fax Number	:	305-551-6079

Provider Business Practice Location Address
First Line	:	11890 SW 8TH ST
Second Line	:	SUITE#300
City	:	MIAMI
State	:	FL
Zip	:	33184-1743
Country	:	US
Telephone Number	:	305-551-8200
Fax Number	:	305-551-6079

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

Provider Enumeration Date	:	05/23/2007
Last Update Date	:	07/08/2007

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