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General NPI Number Information
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NPI Number | 1174544423
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Entity Type | Individual
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Provider Name | MICHAEL ORRANTIA DMD
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Gender | Male
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Dates
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Enumeration Date | 07/22/2006
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Last Update Date | 08/09/2018
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Provider Practice Location Address
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Address Line | 625 EICHENFELD DRIVE
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City | BRANDON
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State | FL
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Zip | 33511
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Country | US
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Telephone | 813-654-3636
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Fax | 813-651-4984
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Provider Business Mailing Address
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Address Line | 625 EICHENFELD DR
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City | BRANDON
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State | FL
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Zip | 33511-5908
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Country | US
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Telephone | 813-654-3636
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Fax | 813-651-4984
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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 | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | DN11659
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License Number State | FL
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