Healthcare Provider Details

I. General information

NPI: 1467568857
Provider Name (Legal Business Name): BIANCA SILVA FLORA DDS, DSC.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/21/2006
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

3500 MYSTIC POINTE DR APT 1106
AVENTURA FL
33180-2581
US

V. Phone/Fax

Practice location:
  • Phone: 954-262-1919
  • Fax: 954-262-1782
Mailing address:
  • Phone: 305-705-0938
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License NumberTPNU#78
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: