Provider Demographics
NPI:1992265227
Name:PLASENCIA MIRABAL, YERANY (DDS)
Entity type:Individual
Prefix:
First Name:YERANY
Middle Name:
Last Name:PLASENCIA MIRABAL
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2423 SW 13TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33145-1210
Mailing Address - Country:US
Mailing Address - Phone:786-389-9994
Mailing Address - Fax:
Practice Address - Street 1:3228 PONCE DE LEON BLVD
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-7239
Practice Address - Country:US
Practice Address - Phone:305-444-7345
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-22
Last Update Date:2021-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL26211122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist