Provider Demographics
NPI:1538838065
Name:VILTRES, YORDANIA
Entity type:Individual
Prefix:
First Name:YORDANIA
Middle Name:
Last Name:VILTRES
Suffix:
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 1:5010 HOLLYWOOD BLVD # 5012
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33021-6557
Mailing Address - Country:US
Mailing Address - Phone:954-266-2999
Mailing Address - Fax:
Practice Address - Street 1:162 N POWERLINE RD
Practice Address - Street 2:
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33069-2514
Practice Address - Country:US
Practice Address - Phone:954-970-7067
Practice Address - Fax:954-970-5171
Is Sole Proprietor?:No
Enumeration Date:2021-09-08
Last Update Date:2021-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist