MEDICARE: CARMEN A FEOLI DDS 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	122300000X	Dentist	DN18037	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	:	1750786786
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CARMEN A FEOLI DDS PA

Provider Business Mailing Address
First Line	:	1490 NE MIAMI GDN DR
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33179-4829
Country	:	US
Telephone Number	:	305-949-5252
Fax Number	:	305-949-5011

Provider Business Practice Location Address
First Line	:	1490 NE MIAMI GDN DR
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33179-4829
Country	:	US
Telephone Number	:	305-949-5252
Fax Number	:	305-949-5011

Authorized Official
Title or Position	:	OWNER
Name	:	CARMEN A FEOLI
Credential	:
Telephone Number	:	305-949-5252

Provider Enumeration Date	:	11/04/2014
Last Update Date	:	11/04/2014

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Directions to “CARMEN A FEOLI DDS PA ” Practice Location

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