Healthcare Provider Details

I. General information

NPI: 1104730316
Provider Name (Legal Business Name): DEF RIVERVIEW PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/02/2026
Last Update Date: 10/02/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10454 STELLING DR
RIVERVIEW FL
33578-7545
US

IV. Provider business mailing address

10454 STELLING DR
RIVERVIEW FL
33578-7545
US

V. Phone/Fax

Practice location:
  • Phone: 813-458-0257
  • Fax:
Mailing address:
  • Phone: 813-458-0257
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number StateNULL

VIII. Authorized Official

Name: EMTEYAZ ASKER
Title or Position: BUSINESS MANAGER
Credential:
Phone: 813-458-0257