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General NPI Number Information
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NPI Number | 1235539370
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Entity Type | Organization
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Legal Business Name | UNIVERSITY OF FLORIDA
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Dates
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Enumeration Date | 08/26/2014
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Last Update Date | 08/26/2014
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Provider Practice Location Address
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Address Line | 9200 113TH ST
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City | SEMINOLE
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State | FL
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Zip | 33772-2800
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Country | US
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Telephone | 727-394-6064
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Fax |
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Provider Business Mailing Address
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Address Line | 11759 78TH TER
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City | SEMINOLE
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State | FL
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Zip | 33772-4049
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DENTAL RESIDENT
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Name | DR. ROSALIA KOLOKITHAS
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Credential |
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Telephone | 727-394-6064
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DRP1276
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License Number State | FL
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