Provider Demographics
NPI:1154505311
Name:MIRABAL, ZARINA BEATRIZ (DMD)
Entity Type:Individual
Prefix:
First Name:ZARINA
Middle Name:BEATRIZ
Last Name:MIRABAL
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:MUNOZ RIVERA ST. #63
Mailing Address - Street 2:
Mailing Address - City:ADJUNTAS
Mailing Address - State:PR
Mailing Address - Zip Code:00601
Mailing Address - Country:US
Mailing Address - Phone:787-630-4739
Mailing Address - Fax:787-844-0233
Practice Address - Street 1:2909 AVE EMILIO FAGOT
Practice Address - Street 2:
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00716-3613
Practice Address - Country:US
Practice Address - Phone:787-844-0233
Practice Address - Fax:787-844-0233
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-24
Last Update Date:2016-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR27761223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice