Organization
LATIN QUARTER DENTAL PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RODOLFO LEA PLAZA DDS (DR.)
(305) 642-8499
Entity
Organization
Contact information
Practice address
1660 SW 1 ST, MIAMI, FL 33135
(305) 642-8499
Mailing address
1660 SW 1ST ST, MIAMI, FL 33135-2105
(305) 642-8499
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DN19240
LICENSE
FL
Enumeration date
10/24/2017
Last updated
10/24/2017
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