Organization
DENTAL GROUP OF SOUTH FLORIDA IV
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROLANDO BELLO (VP)
(305) 542-3197
Entity
Organization
Contact information
Practice address
11373 SW 211TH ST STE 10-11, MIAMI, FL 33189-2245
(305) 542-3197
(786) 713-0959
Mailing address
11373 SW 211TH ST STE 10-11, MIAMI, FL 33189-2245
(305) 542-3197
(786) 713-0959
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
DN17638
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
076710700
—
FL
Enumeration date
04/03/2017
Last updated
04/03/2017
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