Provider Demographics
NPI:1922297225
Name:PEDROSO, ANGELIKA KOEBERNIK (DDS)
Entity Type:Individual
Prefix:DR
First Name:ANGELIKA
Middle Name:KOEBERNIK
Last Name:PEDROSO
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:460 ARTHUR GODFREY RD
Mailing Address - Street 2:
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33140-3504
Mailing Address - Country:US
Mailing Address - Phone:305-674-0656
Mailing Address - Fax:305-674-0714
Practice Address - Street 1:460 ARTHUR GODFREY RD
Practice Address - Street 2:
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33140-3504
Practice Address - Country:US
Practice Address - Phone:305-674-0656
Practice Address - Fax:305-674-0714
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-23
Last Update Date:2007-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN-147021223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice