MEDICARE: ARELLANO DENTAL, 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	122300000X	Dentist	DN19472	FL

General Provider Information

NPI Number	:	1225564347
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ARELLANO DENTAL, P.A.

Provider Business Mailing Address
First Line	:	3835 N LECANTO HWY
Second Line	:
City	:	BEVERLY HILLS
State	:	FL
Zip	:	34465-3506
Country	:	US
Telephone Number	:	786-312-4278
Fax Number	:

Provider Business Practice Location Address
First Line	:	3835 N LECANTO HWY
Second Line	:
City	:	BEVERLY HILLS
State	:	FL
Zip	:	34465-3506
Country	:	US
Telephone Number	:	786-312-4278
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. EVELYN XIOMARA ARELLANO
Credential	:	DENTIST
Telephone Number	:	786-312-4278

Provider Enumeration Date	:	05/10/2017
Last Update Date	:	05/10/2017

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