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General NPI Number Information
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NPI Number | 1578233888
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Entity Type | Individual
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Provider Name | ANA PAULA DE OLIVEIRA OTT DMD
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Gender | Female
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Dates
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Enumeration Date | 09/17/2021
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Last Update Date | 09/17/2021
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Provider Practice Location Address
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Address Line | 6429 RALEIGH STREET METROWEST
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City | ORLANDO
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State | FL
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Zip | 32835-5739
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Country | US
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Telephone | 407-743-5757
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Fax |
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Provider Business Mailing Address
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Address Line | 6230 GOLDEN DEWDROP TRL
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City | WINDERMERE
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State | FL
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Zip | 34786-5697
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Country | US
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Telephone | 407-961-3722
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 25984
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License Number State | FL
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