Provider Demographics
NPI:1477926541
Name:SOUTH FLORIDA SMILES
Entity Type:Organization
Organization Name:SOUTH FLORIDA SMILES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ERNEST
Authorized Official - Middle Name:S
Authorized Official - Last Name:ORPHANOS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:561-477-7171
Mailing Address - Street 1:13590 JOG RD
Mailing Address - Street 2:#1
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33446-3807
Mailing Address - Country:US
Mailing Address - Phone:561-499-1199
Mailing Address - Fax:
Practice Address - Street 1:13590 JOG RD
Practice Address - Street 2:#1
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33446-3807
Practice Address - Country:US
Practice Address - Phone:561-499-1199
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-11
Last Update Date:2015-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN00136991223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty