Provider Demographics
NPI:1811193972
Name:SUBIRATS-TORRES, IBELYS (DMD)
Entity Type:Individual
Prefix:
First Name:IBELYS
Middle Name:
Last Name:SUBIRATS-TORRES
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13220 SW 58TH TER
Mailing Address - Street 2:16-2
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33183-1257
Mailing Address - Country:US
Mailing Address - Phone:786-512-8066
Mailing Address - Fax:
Practice Address - Street 1:16940 SW 94TH CT
Practice Address - Street 2:
Practice Address - City:PALMETTO BAY
Practice Address - State:FL
Practice Address - Zip Code:33157-4429
Practice Address - Country:US
Practice Address - Phone:305-255-4140
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-25
Last Update Date:2010-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN 179401223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice