Provider Demographics
NPI:1295847648
Name:SOMOZA, FRANCISCO JAVIER JR (DDS)
Entity Type:Individual
Prefix:DR
First Name:FRANCISCO
Middle Name:JAVIER
Last Name:SOMOZA
Suffix:JR
Gender:M
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:PO BOX 840937
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33084-2937
Mailing Address - Country:US
Mailing Address - Phone:954-963-9700
Mailing Address - Fax:954-963-7881
Practice Address - Street 1:6800 TAFT ST
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33024-5602
Practice Address - Country:US
Practice Address - Phone:954-963-9700
Practice Address - Fax:954-963-7881
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN14222122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL071323601Medicaid