MEDICARE: DR. MANUEL RICARDO VILARET II DMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	DN9497	FL

General Provider Information

NPI Number	:	1033172127
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MANUEL RICARDO VILARET II DMD

Provider Business Mailing Address
First Line	:	212 7TH AVE N
Second Line	:
City	:	ST PETERSBURG
State	:	FL
Zip	:	33701-2404
Country	:	US
Telephone Number	:	727-480-1736
Fax Number	:	813-231-1812

Provider Business Practice Location Address
First Line	:	2010 E HILLSBOROUGH AVE
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33610-8255
Country	:	US
Telephone Number	:	813-231-1800
Fax Number	:	813-231-1812

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/10/2006
Last Update Date	:	07/08/2007

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