MEDICARE: ANA MARGARITA BLAIN ABDALA

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	DN27505	FL

General Provider Information

NPI Number	:	1780304204
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANA MARGARITA BLAIN ABDALA

Provider Business Mailing Address
First Line	:	15535 SW 120TH ST STE 5
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33196-6216
Country	:	US
Telephone Number	:	786-929-0099
Fax Number	:	786-929-0216

Provider Business Practice Location Address
First Line	:	15535 SW 120TH ST STE 5
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33196-6216
Country	:	US
Telephone Number	:	786-929-0099
Fax Number	:	786-929-0216

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

Provider Enumeration Date	:	09/02/2022
Last Update Date	:	09/16/2025

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