Individual
AMY LYNN IGLESIAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4129 W KENNEDY BLVD, TAMPA, FL 33609-2254
(813) 580-5244
Mailing address
15138 NW 89TH AVE, MIAMI LAKES, FL 33018-1371
(305) 905-2389
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
061851
NY
122300000X
Dentist
Primary
DN25195
FL
390200000X
Student in an Organized Health Care Education/Training Program
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—
Other
Enumeration date
03/07/2020
Last updated
08/27/2024
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