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General NPI Number Information
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NPI Number | 1326782723
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Entity Type | Individual
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Provider Name | RAMA SHAHROUR DMD
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Gender | Female
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Dates
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Enumeration Date | 04/22/2022
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Last Update Date | 06/20/2023
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Provider Practice Location Address
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Address Line | 3711 US 301 S
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City | RIVERVIEW
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State | FL
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Zip | 33578-3694
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Country | US
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Telephone | 352-515-7353
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Fax |
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Provider Business Mailing Address
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Address Line | 10527 BERMUDA ISLE DR
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City | TAMPA
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State | FL
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Zip | 33647-2721
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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 |
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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 | RES.004462
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DN27453
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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