Provider Demographics
NPI:1689844516
Name:MARIANI, ROBINSON & LEYTE-VIDAL LLC
Entity Type:Organization
Organization Name:MARIANI, ROBINSON & LEYTE-VIDAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARCO
Authorized Official - Middle Name:A
Authorized Official - Last Name:LEYTE-VIDAL
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:305-661-7810
Mailing Address - Street 1:6280 SUNSET DR
Mailing Address - Street 2:SUITE 404
Mailing Address - City:SOUTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33143-4827
Mailing Address - Country:US
Mailing Address - Phone:305-661-7810
Mailing Address - Fax:
Practice Address - Street 1:6280 SUNSET DR
Practice Address - Street 2:SUITE 404
Practice Address - City:SOUTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33143-4827
Practice Address - Country:US
Practice Address - Phone:305-661-7810
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-06
Last Update Date:2008-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty