Provider Demographics
NPI:1730330507
Name:OSPINA, GLORIA AMPARO (DDS)
Entity type:Individual
Prefix:DR
First Name:GLORIA
Middle Name:AMPARO
Last Name:OSPINA
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 1:147 ALHAMBRA CIR
Mailing Address - Street 2:111
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-4524
Mailing Address - Country:US
Mailing Address - Phone:305-443-8225
Mailing Address - Fax:305-443-8316
Practice Address - Street 1:147 ALHAMBRA CIR
Practice Address - Street 2:111
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-4524
Practice Address - Country:US
Practice Address - Phone:305-443-8225
Practice Address - Fax:305-443-8316
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-09
Last Update Date:2008-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN13144122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist