Provider Demographics
NPI:1497343164
Name:ALENCAR, SIMONE
Entity Type:Individual
Prefix:DR
First Name:SIMONE
Middle Name:
Last Name:ALENCAR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:503 NW 84TH AVE
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33324-1800
Mailing Address - Country:US
Mailing Address - Phone:678-237-7883
Mailing Address - Fax:
Practice Address - Street 1:901 SE 8TH AVE
Practice Address - Street 2:
Practice Address - City:DEERFIELD BEACH
Practice Address - State:FL
Practice Address - Zip Code:33441-5611
Practice Address - Country:US
Practice Address - Phone:954-426-2298
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-07
Last Update Date:2023-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN25580122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist