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NPI Code Detail

MEDICARE: DR. DANAE VITAL D.D.S.

MEDICARE:  DR. DANAE  VITAL  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
1122300000XDentistDN18585FL

General Provider Information

NPI Number : 1376773895
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DANAE VITAL D.D.S.
Provider Business Mailing Address
First Line : 8910 NW 162ND TER
Second Line :
City : HIALEAH
State : FL
Zip : 33018-6108
Country : US
Telephone Number : 305-819-7398
Fax Number :
Provider Business Practice Location Address
First Line : 1250 SW 27TH AVE STE 206
Second Line :
City : MIAMI
State : FL
Zip : 33135-4748
Country : US
Telephone Number : 305-649-2231
Fax Number : 305-541-0253
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/17/2009
Last Update Date : 04/28/2022

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Directions to “ DR. DANAE VITAL D.D.S.” Practice Location

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