Provider Demographics
NPI:1487866729
Name:CYMER, RENATA (DDS)
Entity Type:Individual
Prefix:DR
First Name:RENATA
Middle Name:
Last Name:CYMER
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 1:18921 NW 2ND AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33169-4008
Mailing Address - Country:US
Mailing Address - Phone:305-652-7333
Mailing Address - Fax:305-652-7345
Practice Address - Street 1:18921 NW 2ND AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33169-4008
Practice Address - Country:US
Practice Address - Phone:305-652-7333
Practice Address - Fax:305-652-7345
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL122981223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL073400400Medicaid