Provider Demographics
NPI:1881986891
Name:COTELO-PARDO, YANEPSI (DDS)
Entity type:Individual
Prefix:DR
First Name:YANEPSI
Middle Name:
Last Name:COTELO-PARDO
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2746 SW 131ST CT
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33175-7184
Mailing Address - Country:US
Mailing Address - Phone:786-398-1325
Mailing Address - Fax:
Practice Address - Street 1:299 ALHAMBRA CIR
Practice Address - Street 2:202
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-5106
Practice Address - Country:US
Practice Address - Phone:305-444-3074
Practice Address - Fax:844-270-7764
Is Sole Proprietor?:No
Enumeration Date:2011-05-10
Last Update Date:2015-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL390200000X
FLDN201311223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program