Organization
MYRIAM TAVERAS D.M.D P.A
Active
Other names
WESTGATE DENTAL
Organization subpart
No
Provider details
NPI number
Authorized official
MYRIAM TAVERAS (DENTIST)
(407) 692-6633
Entity
Organization
Contact information
Practice address
15810 WEST SR 84, SUNRISE, FL 33326
(954) 389-9600
Mailing address
15810 WEST SR 84, SUNRISE, FL 33326
(954) 389-9600
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1598190852
1598190852
FL
Enumeration date
03/02/2020
Last updated
03/02/2020
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