Individual
FARA AMELIA ALFONZO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
13621 SW 84 AVE, MIAMI, FL 33158
(305) 975-1303
Mailing address
13621 SW 84TH AVE, VILLAGE OF PALMETTO BAY, FL 33158-1029
(305) 255-7352
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN011020
FL
Other
Enumeration date
01/26/2007
Last updated
07/08/2007
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