Provider Demographics
NPI:1720663388
Name:POCATERRA, HELENA (MS)
Entity Type:Individual
Prefix:
First Name:HELENA
Middle Name:
Last Name:POCATERRA
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3148 OHIO ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33133-4447
Mailing Address - Country:US
Mailing Address - Phone:786-375-1472
Mailing Address - Fax:
Practice Address - Street 1:848 BRICKELL AVE STE 920
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33131-2976
Practice Address - Country:US
Practice Address - Phone:305-372-8212
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-16
Last Update Date:2023-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDRPM2276122300000X, 390200000X
FLDRP2276390200000X
FLDN280561223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program