Healthcare Provider Details

I. General information

NPI: 1295656486
Provider Name (Legal Business Name): DR. ANDREZA CALAZANS RODRIGUES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/23/2026
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3400 GULF TO BAY BLVD
CLEARWATER FL
33759-4514
US

IV. Provider business mailing address

3400 GULF TO BAY BLVD
CLEARWATER FL
33759-4514
US

V. Phone/Fax

Practice location:
  • Phone: 813-574-5380
  • Fax:
Mailing address:
  • Phone: 813-574-5380
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDTP882
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: