Healthcare Provider Details

I. General information

NPI: 1124133426
Provider Name (Legal Business Name): ROMER A OCANTO D.D.S
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/20/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3200 S UNIVERSITY DR
DAVIE FL
33328-2018
US

IV. Provider business mailing address

1940 NE 2ND AVE APT J104
WILTON MANORS FL
33305-2079
US

V. Phone/Fax

Practice location:
  • Phone: 954-262-1910
  • Fax: 954-262-1782
Mailing address:
  • Phone: 954-829-4986
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License NumberDN17762
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: