Provider Demographics
NPI:1457476046
Name:MADERAL-COZAD, ANA (DDS)
Entity Type:Individual
Prefix:DR
First Name:ANA
Middle Name:
Last Name:MADERAL-COZAD
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 1:7725 NW 146TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33016-1559
Mailing Address - Country:US
Mailing Address - Phone:305-632-5338
Mailing Address - Fax:305-827-8109
Practice Address - Street 1:7725 NW 146TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33016-1559
Practice Address - Country:US
Practice Address - Phone:305-632-5338
Practice Address - Fax:305-558-9118
Is Sole Proprietor?:No
Enumeration Date:2007-03-20
Last Update Date:2020-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN11484122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist