Provider Demographics
NPI:1467220418
Name:GIO HEALTH DENTAL GROUP LLC
Entity Type:Organization
Organization Name:GIO HEALTH DENTAL GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MAURO
Authorized Official - Middle Name:
Authorized Official - Last Name:CARBALLO
Authorized Official - Suffix:
Authorized Official - Credentials:DENTIST
Authorized Official - Phone:305-912-8603
Mailing Address - Street 1:900 PARK CENTRE BLVD STE 400
Mailing Address - Street 2:
Mailing Address - City:MIAMI GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33169-5367
Mailing Address - Country:US
Mailing Address - Phone:305-912-8603
Mailing Address - Fax:
Practice Address - Street 1:900 PARK CENTRE BLVD STE 400
Practice Address - Street 2:
Practice Address - City:MIAMI GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33169-5367
Practice Address - Country:US
Practice Address - Phone:305-912-8603
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-19
Last Update Date:2023-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty