Provider Demographics
NPI:1346857133
Name:YUMAR, ELSA (DMD)
Entity Type:Individual
Prefix:DR
First Name:ELSA
Middle Name:
Last Name:YUMAR
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 1:8981 SW 142ND AVE APT 12-36
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-1218
Mailing Address - Country:US
Mailing Address - Phone:786-208-9477
Mailing Address - Fax:
Practice Address - Street 1:8383 PINES BLVD
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33024-6607
Practice Address - Country:US
Practice Address - Phone:954-436-8000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-25
Last Update Date:2020-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN25490122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist