Provider Demographics
NPI:1386790202
Name:HORTA, REINALDO (DMD)
Entity type:Individual
Prefix:DR
First Name:REINALDO
Middle Name:
Last Name:HORTA
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8550 NW 141ST LN
Mailing Address - Street 2:#201
Mailing Address - City:MIAMI LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33016-6734
Mailing Address - Country:US
Mailing Address - Phone:305-825-7459
Mailing Address - Fax:
Practice Address - Street 1:16363 NW 67TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33014-6044
Practice Address - Country:US
Practice Address - Phone:305-821-2233
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-25
Last Update Date:2007-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN 133451223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice