Provider Demographics
NPI:1356515035
Name:VINUELA, LARRY (DMD)
Entity type:Individual
Prefix:DR
First Name:LARRY
Middle Name:
Last Name:VINUELA
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 1:9001 SW 93RD AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33176-2066
Mailing Address - Country:US
Mailing Address - Phone:305-431-6440
Mailing Address - Fax:
Practice Address - Street 1:15450 NEW BARN RD
Practice Address - Street 2:#101
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33014-2169
Practice Address - Country:US
Practice Address - Phone:305-557-7775
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-14
Last Update Date:2014-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
FLDN19253122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program