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Provider Information for 1578940912



MIRTHA AMADOR DMD, PA

Gender: FEMALE

Individual NPI: 1578940912

Calendar   Last Updated:  2015-05-06
  Certification Date: 

Details

Name Value
NPI 1578940912
Enumeration Date 2015-05-06
NPI Type 1 - Individual
Sole Proprietor YES
Status Active
Mailing Address 357 ALMERIA AVE STE 105
CORAL GABLES, FL 33134-5801
United States

Phone: 305-569-9001 | Fax: 305-444-9882
View Map External Link
Primary Practice Address 357 ALMERIA AVE STE 105
CORAL GABLES, FL 33134-5801
United States

Phone: 305-569-9001 | Fax: 305-444-9882
View Map External Link
Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 122300000X - Dentist FL 13027