MEDICARE: DR. ANA R DE FERIA 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	122300000X	Dentist	23408	FL

General Provider Information

NPI Number	:	1346735503
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANA R DE FERIA DMD

Provider Business Mailing Address
First Line	:	2410 SW 142ND PL
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33175-7096
Country	:	US
Telephone Number	:	786-712-9381
Fax Number	:

Provider Business Practice Location Address
First Line	:	7200 NW 7TH ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33126-2948
Country	:	US
Telephone Number	:	305-264-0063
Fax Number	:

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

Provider Enumeration Date	:	06/28/2018
Last Update Date	:	06/28/2018

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