Healthcare Provider Details

I. General information

NPI: 1134922727
Provider Name (Legal Business Name): SEBASTIEN BLEAU DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/29/2025
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6772 FOREST HILL BLVD
GREENACRES FL
33413-3322
US

IV. Provider business mailing address

6772 FOREST HILL BLVD
GREENACRES FL
33413-3322
US

V. Phone/Fax

Practice location:
  • Phone: 561-966-3531
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number31557
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: