MEDICARE: DR. YENEIR URQUIZA DIGGLE D.M.D.

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	DN19806	FL
2	1223G0001X	General Practice Dentistry	DN 19806	FL

General Provider Information

NPI Number	:	1629325592
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. YENEIR URQUIZA DIGGLE D.M.D.

Provider Business Mailing Address
First Line	:	700 SE BECKER RD # 101
Second Line	:
City	:	PORT SAINT LUCIE
State	:	FL
Zip	:	34984-6621
Country	:	US
Telephone Number	:	786-301-5629
Fax Number	:

Provider Business Practice Location Address
First Line	:	4000 ATLANTIC BLVD STE 101
Second Line	:
City	:	VERO BEACH
State	:	FL
Zip	:	32960-2479
Country	:	US
Telephone Number	:	772-567-2132
Fax Number	:

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

Provider Enumeration Date	:	08/10/2012
Last Update Date	:	01/16/2025

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