MEDICARE: DR. GABRIELLA VALLADARES DMD

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	DN30503	FL

General Provider Information

NPI Number	:	1962294801
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GABRIELLA VALLADARES DMD

Provider Business Mailing Address
First Line	:	1901 NW SOUTH RIVER DR APT 33
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33125-2757
Country	:	US
Telephone Number	:	305-458-4016
Fax Number	:

Provider Business Practice Location Address
First Line	:	3120 N MIAMI AVE
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33127-3718
Country	:	US
Telephone Number	:	786-724-0418
Fax Number	:

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

Provider Enumeration Date	:	05/19/2025
Last Update Date	:	07/08/2025

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