Healthcare Provider Details

I. General information

NPI: 1215857172
Provider Name (Legal Business Name): THRIVE AIRWAY AND TONGUE TIE CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/20/2026
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9675 W BROWARD BLVD
PLANTATION FL
33324-2321
US

IV. Provider business mailing address

9675 W BROWARD BLVD
PLANTATION FL
33324-2321
US

V. Phone/Fax

Practice location:
  • Phone: 954-669-1450
  • Fax:
Mailing address:
  • Phone: 954-669-1450
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. RITA PATEL
Title or Position: OWNER
Credential: DMD
Phone: 305-310-6858