Provider Demographics
NPI:1124446281
Name:ANILLO DENTAL CENTER INC
Entity type:Organization
Organization Name:ANILLO DENTAL CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JUAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ANILLO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:305-382-5000
Mailing Address - Street 1:10201 HAMMOCKS BLVD
Mailing Address - Street 2:146
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:
Practice Address - Street 1:10201 HAMMOCKS BLVD
Practice Address - Street 2:146
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:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-04
Last Update Date:2014-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN13030122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL4783552OtherMIAMI-DADE COUNTY PROPERTY APPRAISER
FL13-64-06293OtherFLORIDA DEPARMENT OF HEALTH
FLANILLO DENTAL CENTEROtherFLORIDA DEPARTMENT OF STATE DIVISION OF CORPORATIONS