Provider Demographics
NPI:1093950636
Name:CARVAJAL, GREICY CAROLINA (BS)
Entity Type:Individual
Prefix:
First Name:GREICY
Middle Name:CAROLINA
Last Name:CARVAJAL
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14232 SW 146TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-6791
Mailing Address - Country:US
Mailing Address - Phone:954-907-9700
Mailing Address - Fax:
Practice Address - Street 1:8940 N KENDALL DR
Practice Address - Street 2:604E
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-2148
Practice Address - Country:US
Practice Address - Phone:305-595-1905
Practice Address - Fax:305-595-2219
Is Sole Proprietor?:No
Enumeration Date:2008-12-11
Last Update Date:2008-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes126800000XDental ProvidersDental Assistant