MEDICARE: DR. ANGELA MARIA OSPINA DDS

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 17493	FL

General Provider Information

NPI Number	:	1508042649
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANGELA MARIA OSPINA DDS

Provider Business Mailing Address
First Line	:	9860 NW 49TH TER
Second Line	:
City	:	DORAL
State	:	FL
Zip	:	33178-1921
Country	:	US
Telephone Number	:	786-506-2429
Fax Number	:	305-591-3023

Provider Business Practice Location Address
First Line	:	5171 SW 8TH ST
Second Line	:
City	:	CORAL GABLES
State	:	FL
Zip	:	33134-2474
Country	:	US
Telephone Number	:	305-567-0236
Fax Number	:	305-442-9333

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

Provider Enumeration Date	:	01/19/2008
Last Update Date	:	01/19/2008

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