Healthcare Provider Details

I. General information

NPI: 1144530460
Provider Name (Legal Business Name): DR. ANDRE BAPTISTE, D.D.S., P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/20/2010
Last Update Date: 10/20/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8907 CONROY WINDERMERE RD SUITE E2 & E3
ORLANDO FL
32835-3127
US

IV. Provider business mailing address

8907 CONROY WINDERMERE RD SUITE E2 & E3
ORLANDO FL
32835-3127
US

V. Phone/Fax

Practice location:
  • Phone: 407-217-2927
  • Fax: 407-294-1099
Mailing address:
  • Phone: 407-217-2927
  • Fax: 407-294-1099

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License NumberDN15927
License Number StateFL

VIII. Authorized Official

Name: ANDRE BAPTISTE
Title or Position: OWNER
Credential: D.D.S.
Phone: 407-217-2927