Healthcare Provider Details

I. General information

NPI: 1205072824
Provider Name (Legal Business Name): RHINA UM DMD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/02/2009
Last Update Date: 01/02/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11500 UNIVERSITY BLVD SUITE 101
ORLANDO FL
32817-2197
US

IV. Provider business mailing address

11500 UNIVERSITY BLVD SUITE 101
ORLANDO FL
32817-2197
US

V. Phone/Fax

Practice location:
  • Phone: 407-737-6464
  • Fax: 407-386-9088
Mailing address:
  • Phone: 407-737-6464
  • Fax: 407-386-9088

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDN16235
License Number StateFL

VIII. Authorized Official

Name: DR. RHINA UM
Title or Position: PRESIDENT
Credential:
Phone: 407-737-6464