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General NPI Number Information
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NPI Number | 1134365265
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Entity Type | Individual
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Provider Name | NAZIK H ELRAYAH D.D.S
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Gender | Female
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Dates
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Enumeration Date | 12/18/2008
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Last Update Date | 12/22/2021
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Provider Practice Location Address
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Address Line | 6302 MANATEE AVE W
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City | BRADENTON
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State | FL
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Zip | 34209-2377
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Country | US
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Telephone | 941-792-2965
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Fax | 941-251-8158
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Provider Business Mailing Address
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Address Line | 13120 BLISS LOOP
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City | LAKEWOOD RANCH
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State | FL
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Zip | 34211-4071
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Country | US
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Telephone | 614-477-4460
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DN26541
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License Number State | FL
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