Provider Demographics
NPI:1043943012
Name:HADAD, RAQUEL (DDS)
Entity Type:Individual
Prefix:
First Name:RAQUEL
Middle Name:
Last Name:HADAD
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14195 SW 87TH ST APT 106B
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33183-4419
Mailing Address - Country:US
Mailing Address - Phone:786-468-6942
Mailing Address - Fax:
Practice Address - Street 1:2332 SW 82ND CT
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33155-1247
Practice Address - Country:US
Practice Address - Phone:786-267-0218
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-06
Last Update Date:2022-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL272531223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice