Healthcare Provider Details

I. General information

NPI: 1093050676
Provider Name (Legal Business Name): MARIA E NAZCO BATISTA DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/07/2012
Last Update Date: 01/31/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8108 N NEBRASKA AVE
TAMPA FL
33604-3103
US

IV. Provider business mailing address

PO BOX 82969
TAMPA FL
33682-2969
US

V. Phone/Fax

Practice location:
  • Phone: 813-712-1930
  • Fax: 813-405-3924
Mailing address:
  • Phone: 813-866-0930
  • Fax: 813-405-3924

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDN19998
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: