Provider Demographics
NPI:1528751633
Name:MIAMI ISMILE
Entity type:Organization
Organization Name:MIAMI ISMILE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SHEILA
Authorized Official - Middle Name:
Authorized Official - Last Name:RONQUILLO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-591-0080
Mailing Address - Street 1:11500 NW 7TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33168-2506
Mailing Address - Country:US
Mailing Address - Phone:786-591-0080
Mailing Address - Fax:786-772-7244
Practice Address - Street 1:11500 NW 7TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33168-2506
Practice Address - Country:US
Practice Address - Phone:786-591-0080
Practice Address - Fax:786-772-7244
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-02
Last Update Date:2025-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty