Provider Demographics
NPI:1336233964
Name:GRANDA, FRANCISCO M (DMD, MS, MD)
Entity Type:Individual
Prefix:DR
First Name:FRANCISCO
Middle Name:M
Last Name:GRANDA
Suffix:
Gender:M
Credentials:DMD, MS, MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8000 S.W. 117 AVENUE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33183-4803
Mailing Address - Country:US
Mailing Address - Phone:305-553-9848
Mailing Address - Fax:305-553-9347
Practice Address - Street 1:8000 S.W. 117 AVENUE
Practice Address - Street 2:SUITE 100
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33183-4803
Practice Address - Country:US
Practice Address - Phone:305-553-9848
Practice Address - Fax:305-553-9347
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN105081223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery