Provider Demographics
NPI:1942526884
Name:FLORIDA HEALTHY SMILES INC.
Entity Type:Organization
Organization Name:FLORIDA HEALTHY SMILES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT / DENTIST
Authorized Official - Prefix:MS
Authorized Official - First Name:ROSA
Authorized Official - Middle Name:MARIA
Authorized Official - Last Name:SOLER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:305-569-9966
Mailing Address - Street 1:555 BILTMORE WAY STE 105
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-5757
Mailing Address - Country:US
Mailing Address - Phone:305-569-9966
Mailing Address - Fax:
Practice Address - Street 1:555 BILTMORE WAY STE 105
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-5757
Practice Address - Country:US
Practice Address - Phone:305-569-9966
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-16
Last Update Date:2010-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11884122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL073085800Medicaid