Healthcare Provider Details

I. General information

NPI: 1407698608
Provider Name (Legal Business Name): CINDY C DI NICOLA VALDIVIEZO DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/10/2024
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3736 TURMAN LOOP
WESLEY CHAPEL FL
33544-7795
US

IV. Provider business mailing address

30626 BIRDHOUSE DR
WESLEY CHAPEL FL
33545-1305
US

V. Phone/Fax

Practice location:
  • Phone: 813-492-2307
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDN32383
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: