Provider Demographics
NPI:1598361115
Name:LUZARDO DENTAL LLC
Entity Type:Organization
Organization Name:LUZARDO DENTAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:FLOR
Authorized Official - Middle Name:
Authorized Official - Last Name:LUZARDO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:786-451-9171
Mailing Address - Street 1:7940 SW 163RD PL
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33193-3427
Mailing Address - Country:US
Mailing Address - Phone:305-890-3180
Mailing Address - Fax:
Practice Address - Street 1:6933 W COMMERCIAL BLVD
Practice Address - Street 2:
Practice Address - City:LAUDERHILL
Practice Address - State:FL
Practice Address - Zip Code:33319-2119
Practice Address - Country:US
Practice Address - Phone:954-724-8486
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-09
Last Update Date:2020-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental