Provider Demographics
NPI:1043837180
Name:GONZALEZ FARINAS, KATIA (DMD)
Entity type:Individual
Prefix:DR
First Name:KATIA
Middle Name:
Last Name:GONZALEZ FARINAS
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3654 SW 162ND AVE
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33027-4509
Mailing Address - Country:US
Mailing Address - Phone:786-612-0903
Mailing Address - Fax:
Practice Address - Street 1:3654 SW 162ND AVE
Practice Address - Street 2:
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33027-4509
Practice Address - Country:US
Practice Address - Phone:786-612-0903
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-05
Last Update Date:2020-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN251031223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice