Healthcare Provider Details

I. General information

NPI: 1841120433
Provider Name (Legal Business Name): AMELIA CACERES DMD PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/23/2026
Last Update Date: 05/23/2026
Certification Date: 05/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1437 COURT ST
CLEARWATER FL
33756-6146
US

IV. Provider business mailing address

1437 COURT ST
CLEARWATER FL
33756-6146
US

V. Phone/Fax

Practice location:
  • Phone: 727-443-5514
  • Fax: 727-447-6294
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: AMELIA M CACERES
Title or Position: PRESIDENT
Credential: DMD
Phone: 239-246-6012