MEDICARE: NITZA PERDIGON-CANGAHUALA 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	DN0010368	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1720006174
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NITZA PERDIGON-CANGAHUALA DDS

Provider Business Mailing Address
First Line	:	5607 NW 27TH AVE
Second Line	:	SUITE 1
City	:	MIAMI
State	:	FL
Zip	:	33142-2826
Country	:	US
Telephone Number	:	305-805-1700
Fax Number	:	305-805-1715

Provider Business Practice Location Address
First Line	:	18360 NW 7TH AVE
Second Line	:
City	:	MIAMI GARDENS
State	:	FL
Zip	:	33169-4410
Country	:	US
Telephone Number	:	305-637-6400
Fax Number	:	305-805-1715

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

Provider Enumeration Date	:	07/17/2006
Last Update Date	:	04/11/2017

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Directions to “ NITZA PERDIGON-CANGAHUALA DDS” Practice Location

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