MEDICARE: DENTAL GROUP OF SOUTH FLORIDA,INC

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	DN17638	FL

General Provider Information

NPI Number	:	1841320074
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DENTAL GROUP OF SOUTH FLORIDA,INC

Provider Business Mailing Address
First Line	:	14060 SW 39TH ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33175-6423
Country	:	US
Telephone Number	:	305-444-8591
Fax Number	:	305-444-6988

Provider Business Practice Location Address
First Line	:	14060 SW 39TH ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33175-6423
Country	:	US
Telephone Number	:	305-444-8591
Fax Number	:	305-444-6988

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. MARIA J ALVAREZ
Credential	:	DDS
Telephone Number	:	305-444-8591

Provider Enumeration Date	:	03/06/2007
Last Update Date	:	08/22/2020

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