Provider Demographics
NPI:1750442075
Name:ANILLO-SARMIENTO, MANUEL F (DMD)
Entity type:Individual
Prefix:DR
First Name:MANUEL
Middle Name:F
Last Name:ANILLO-SARMIENTO
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 1:10201 HAMMOCKS BLVD
Mailing Address - Street 2:SUITE 146
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33196-4712
Mailing Address - Country:US
Mailing Address - Phone:305-382-5000
Mailing Address - Fax:305-382-1615
Practice Address - Street 1:10201 HAMMOCKS BLVD
Practice Address - Street 2:SUITE 146
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33196-4712
Practice Address - Country:US
Practice Address - Phone:305-382-5000
Practice Address - Fax:305-382-1615
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN137501223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice