Healthcare Provider Details

I. General information

NPI: 1467969444
Provider Name (Legal Business Name): VIPCARE DENTAL PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/29/2017
Last Update Date: 05/13/2021
Certification Date: 05/13/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8409 SW 80TH ST
OCALA FL
34481-9117
US

IV. Provider business mailing address

601 S HARBOUR ISLAND BLVD STE 213
TAMPA FL
33602-5925
US

V. Phone/Fax

Practice location:
  • Phone: 352-414-1922
  • Fax:
Mailing address:
  • Phone: 813-340-1644
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: AMI M PAGIDIPATI
Title or Position: CEO
Credential: DMD
Phone: 813-340-1644