Provider Demographics
NPI:1689239311
Name:DENTAL GROUP OF SOUTH FLORIDA II
Entity Type:Organization
Organization Name:DENTAL GROUP OF SOUTH FLORIDA II
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:
Authorized Official - Last Name:ALVAREZ
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:305-251-4262
Mailing Address - Street 1:11336 SW 184TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33157-6553
Mailing Address - Country:US
Mailing Address - Phone:305-251-4262
Mailing Address - Fax:786-242-6351
Practice Address - Street 1:11336 SW 184TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33157-6553
Practice Address - Country:US
Practice Address - Phone:305-251-4262
Practice Address - Fax:786-242-6351
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-08
Last Update Date:2019-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty