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NPI Code Detail

MEDICARE: TATIANA LEMES CARO QUINTILIANO D.D.S.

MEDICARE:   TATIANA LEMES CARO QUINTILIANO  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
11223P0700XProsthodonticsDN20001FL

General Provider Information

NPI Number : 1225377161
Entity Type Code : Individual
Provider Name (Legal Business Name) : TATIANA LEMES CARO QUINTILIANO D.D.S.
Provider Business Mailing Address
First Line : 9560 NW 13TH ST
Second Line :
City : PLANTATION
State : FL
Zip : 33322-4810
Country : US
Telephone Number : 954-472-8005
Fax Number :
Provider Business Practice Location Address
First Line : 2631 E ATLANTIC BLVD
Second Line :
City : POMPANO BEACH
State : FL
Zip : 33062-4939
Country : US
Telephone Number : 954-942-4048
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/13/2013
Last Update Date : 02/13/2013

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Directions to “ TATIANA LEMES CARO QUINTILIANO D.D.S.” Practice Location

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