Healthcare Provider Details

I. General information

NPI: 1144093485
Provider Name (Legal Business Name): TOTS RELEASE CENTERS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/30/2023
Last Update Date: 10/30/2023
Certification Date: 10/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6026 PARK BLVD N FL 6026
PINELLAS PARK FL
33781-3228
US

IV. Provider business mailing address

2424 W TAMPA BAY BLVD APT F104
TAMPA FL
33607-1324
US

V. Phone/Fax

Practice location:
  • Phone: 727-238-7722
  • Fax:
Mailing address:
  • Phone: 407-468-7609
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. CAROLINA ESCOBEDO
Title or Position: SOLE MEMBER
Credential: DMD
Phone: 407-468-7609