Provider Demographics
NPI:1922052844
Name:KABLAWI, FADI (DMD)
Entity Type:Individual
Prefix:DR
First Name:FADI
Middle Name:
Last Name:KABLAWI
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12885 PINE RD
Mailing Address - Street 2:
Mailing Address - City:NORTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33181-2418
Mailing Address - Country:US
Mailing Address - Phone:305-776-7222
Mailing Address - Fax:305-248-7717
Practice Address - Street 1:27501 S DIXIE HWY
Practice Address - Street 2:STE 300
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33032-8235
Practice Address - Country:US
Practice Address - Phone:305-245-7733
Practice Address - Fax:305-248-7717
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN173591223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice