Provider Demographics
NPI:1932112828
Name:ALBERTO, JUAN (D D S)
Entity Type:Individual
Prefix:DR
First Name:JUAN
Middle Name:
Last Name:ALBERTO
Suffix:
Gender:M
Credentials:D D S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 W CYPRESS CREEK RD
Mailing Address - Street 2:SUITE 580
Mailing Address - City:FT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33309-2075
Mailing Address - Country:US
Mailing Address - Phone:954-376-7638
Mailing Address - Fax:954-566-1674
Practice Address - Street 1:800 W CYPRESS CREEK RD
Practice Address - Street 2:SUITE 580
Practice Address - City:FT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33309-2075
Practice Address - Country:US
Practice Address - Phone:954-376-7638
Practice Address - Fax:954-566-1674
Is Sole Proprietor?:No
Enumeration Date:2006-08-14
Last Update Date:2016-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN 176371223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice