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General NPI Number Information
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NPI Number | 1225414402
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Entity Type | Individual
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Provider Name | ERNESTO LEOPOLDO GUERRA ANDRADE DDS
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Gender | Male
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Dates
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Enumeration Date | 08/10/2015
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Last Update Date | 06/25/2024
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Provider Practice Location Address
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Address Line | 14442 BRUCE B DOWNS BLVD
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City | TAMPA
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State | FL
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Zip | 33613-2612
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Country | US
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Telephone | 813-866-7080
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Fax |
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Provider Business Mailing Address
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Address Line | 5823 BOWEN DANIEL DR UNIT 802
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City | TAMPA
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State | FL
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Zip | 33616-1474
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Country | US
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Telephone | 787-613-5586
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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 | DN 21508
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License Number State | FL
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