Provider Demographics
NPI:1932429461
Name:TRIANA, NELCY MARIA
Entity Type:Individual
Prefix:
First Name:NELCY
Middle Name:MARIA
Last Name:TRIANA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:NELCY
Other - Middle Name:MARIA
Other - Last Name:TRIANA CONCEPCION
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:7001 SW 89TH CT
Mailing Address - Street 2:APT. 5
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33173-2454
Mailing Address - Country:US
Mailing Address - Phone:305-310-2828
Mailing Address - Fax:
Practice Address - Street 1:7001 SW 89TH CT
Practice Address - Street 2:APT. 5
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-2454
Practice Address - Country:US
Practice Address - Phone:305-310-2828
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-07
Last Update Date:2010-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN190171223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice