Provider Demographics
NPI:1164988374
Name:CARDENAS, MARIANNE BEATRIZ (DMD)
Entity Type:Individual
Prefix:
First Name:MARIANNE
Middle Name:BEATRIZ
Last Name:CARDENAS
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 1:1674 SW 131ST PLACE CIR E
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33175-1205
Mailing Address - Country:US
Mailing Address - Phone:305-781-3311
Mailing Address - Fax:
Practice Address - Street 1:7301 W PALMETTO PARK RD STE 203B
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33433-3456
Practice Address - Country:US
Practice Address - Phone:561-391-6066
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-12
Last Update Date:2021-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN256951223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry