Provider Demographics
NPI:1346837556
Name:PEREZ URBAY, MAYDELIS (RDH)
Entity Type:Individual
Prefix:
First Name:MAYDELIS
Middle Name:
Last Name:PEREZ URBAY
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 NW 87TH AVE STE 215
Mailing Address - Street 2:
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33172-2657
Mailing Address - Country:US
Mailing Address - Phone:786-953-6550
Mailing Address - Fax:
Practice Address - Street 1:2000 NW 87TH AVE STE 215
Practice Address - Street 2:
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33172-2657
Practice Address - Country:US
Practice Address - Phone:786-953-6550
Practice Address - Fax:786-431-5918
Is Sole Proprietor?:No
Enumeration Date:2020-12-22
Last Update Date:2020-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDH28126124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist