Provider Demographics
NPI:1164714176
Name:APONTE-BARRIOS, SECIL
Entity Type:Individual
Prefix:
First Name:SECIL
Middle Name:
Last Name:APONTE-BARRIOS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1350 SW 57TH AVE STE 106
Mailing Address - Street 2:
Mailing Address - City:WEST MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33144-5700
Mailing Address - Country:US
Mailing Address - Phone:305-265-6120
Mailing Address - Fax:305-265-6121
Practice Address - Street 1:1350 SW 57TH AVE STE 106
Practice Address - Street 2:
Practice Address - City:WEST MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33144-5700
Practice Address - Country:US
Practice Address - Phone:305-265-6120
Practice Address - Fax:305-265-6121
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-10
Last Update Date:2014-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
FLDN201821223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program