Healthcare Provider Details

I. General information

NPI: 1316308547
Provider Name (Legal Business Name): RENATO J. AVES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/16/2016
Last Update Date: 08/13/2024
Certification Date: 08/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7720 W WATERS AVE
TAMPA FL
33615-1813
US

IV. Provider business mailing address

7720 W WATERS AVE
TAMPA FL
33615-1813
US

V. Phone/Fax

Practice location:
  • Phone: 813-885-6555
  • Fax: 813-882-8018
Mailing address:
  • Phone: 813-885-6555
  • Fax: 813-882-8018

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number
License Number State

VIII. Authorized Official

Name: DR. RENATO J AVES
Title or Position: OWNER
Credential: DDS
Phone: 813-885-6555