MEDICARE: DR. ANA T SOTERAS D.D.S.,P.A

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	DN-0013553	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1194897876
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANA T SOTERAS D.D.S.,P.A

Provider Business Mailing Address
First Line	:	2701 SW 142ND AVE
Second Line	:	4827 NW 183RD ST
City	:	MIAMI
State	:	FL
Zip	:	33175-8014
Country	:	US
Telephone Number	:	305-225-2530
Fax Number	:	305-225-6411

Provider Business Practice Location Address
First Line	:	2701 SW 142ND AVE
Second Line	:	4827 NW 183RD ST
City	:	MIAMI
State	:	FL
Zip	:	33175-8014
Country	:	US
Telephone Number	:	305-225-2530
Fax Number	:	305-225-6411

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

Provider Enumeration Date	:	11/15/2006
Last Update Date	:	06/20/2008

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