Healthcare Provider Details

I. General information

NPI: 1740366103
Provider Name (Legal Business Name): JEFFREY ABRIL D.M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/28/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10845 BLOOMINGDALE AVE
RIVERVIEW FL
33569-3616
US

IV. Provider business mailing address

5672 SAMTER CT
TAMPA FL
33611-4300
US

V. Phone/Fax

Practice location:
  • Phone: 813-662-6100
  • Fax:
Mailing address:
  • Phone: 813-230-3873
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDN15356
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: