Provider Demographics
NPI:1316127251
Name:ASCUNTAR, LETICIA II
Entity type:Individual
Prefix:MRS
First Name:LETICIA
Middle Name:
Last Name:ASCUNTAR
Suffix:II
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8700 N KENDALL DR
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33176-2206
Mailing Address - Country:US
Mailing Address - Phone:305-595-4122
Mailing Address - Fax:
Practice Address - Street 1:8700 N KENDALL DR
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-2206
Practice Address - Country:US
Practice Address - Phone:305-595-4122
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-08
Last Update Date:2007-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL126800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes126800000XDental ProvidersDental Assistant