1548387806 NPI number — ANGELICA CARDENAS-MANSUR D.M.D.,P.A.

Table of content: ANGELICA CARDENAS-MANSUR D.M.D.,P.A. (NPI 1548387806)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1548387806 NPI number — ANGELICA CARDENAS-MANSUR D.M.D.,P.A.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CARDENAS-MANSUR
Provider First Name:
ANGELICA
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
D.M.D.,P.A.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1548387806
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3030 NE 41ST TER
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HOMESTEAD
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33033-6619
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
305-245-3366
Provider Business Mailing Address Fax Number:
305-246-5200

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3030 NE 41ST TER
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HOMESTEAD
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33033-6619
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
305-245-3366
Provider Business Practice Location Address Fax Number:
305-246-5200
Provider Enumeration Date:
03/23/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 122300000X , with the licence number:  DN16290 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com