Provider Demographics
NPI:1811044191
Name:MARIN, RITA F
Entity Type:Individual
Prefix:MS
First Name:RITA
Middle Name:F
Last Name:MARIN
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:RITA
Other - Middle Name:F
Other - Last Name:MARIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DMD
Mailing Address - Street 1:330 SW 27 AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33135
Mailing Address - Country:US
Mailing Address - Phone:305-643-6645
Mailing Address - Fax:305-643-6622
Practice Address - Street 1:330 SW 27 AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33135-2961
Practice Address - Country:US
Practice Address - Phone:305-643-6645
Practice Address - Fax:305-643-6622
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN000132321223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice