Provider Demographics
NPI:1558525758
Name:GLORIA A. OSPINA DDS PA
Entity Type:Organization
Organization Name:GLORIA A. OSPINA DDS PA
Other - Org Name:GABLES PERFECT SMILE
Other - Org Type:Other Name
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:MS
Authorized Official - First Name:GLORIA
Authorized Official - Middle Name:AMPARO
Authorized Official - Last Name:OSPINA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:305-443-8225
Mailing Address - Street 1:1805 PONCE DE LEON BLVD STE 401
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-4455
Mailing Address - Country:US
Mailing Address - Phone:305-443-8225
Mailing Address - Fax:305-443-8316
Practice Address - Street 1:1805 PONCE DE LEON BLVD STE 401
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-4455
Practice Address - Country:US
Practice Address - Phone:305-443-8225
Practice Address - Fax:305-443-8316
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-16
Last Update Date:2016-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN 13144261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental