Provider Demographics
NPI:1356647986
Name:MOSQUERA, CAROLINA MARIA (DDS)
Entity Type:Individual
Prefix:
First Name:CAROLINA
Middle Name:MARIA
Last Name:MOSQUERA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13421 SW 25TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33175-1152
Mailing Address - Country:US
Mailing Address - Phone:305-989-1887
Mailing Address - Fax:
Practice Address - Street 1:299 ALHAMBRA CIR
Practice Address - Street 2:#301
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-5106
Practice Address - Country:US
Practice Address - Phone:305-989-1887
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-01-29
Last Update Date:2013-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN 19028122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist