MEDICARE: MARIA CLAUDIA SEGRERA PA

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	261QD0000X	Dental Clinic/Center

General Provider Information

NPI Number	:	1710415294
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MARIA CLAUDIA SEGRERA PA

Provider Business Mailing Address
First Line	:	16636 SHERIDAN ST
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33331-4128
Country	:	US
Telephone Number	:	954-228-6661
Fax Number	:

Provider Business Practice Location Address
First Line	:	16636 SHERIDAN ST
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33331-4128
Country	:	US
Telephone Number	:	954-228-6661
Fax Number	:

Authorized Official
Title or Position	:	DOCTOR
Name	:	DR. MARIA SEGRERA
Credential	:	DMD
Telephone Number	:	954-228-6661

Provider Enumeration Date	:	05/30/2017
Last Update Date	:	07/21/2022

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