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General NPI Number Information
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NPI Number | 1609492578
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Entity Type | Individual
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Provider Name | RUBEN GUSTAVO DABOIN AREVALO DDS
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Gender | Male
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Dates
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Enumeration Date | 06/17/2020
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Last Update Date | 11/14/2024
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Provider Practice Location Address
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Address Line | 1378 S NARCOOSSEE RD
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City | SAINT CLOUD
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State | FL
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Zip | 34771-7251
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Country | US
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Telephone | 407-593-0600
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Fax | 407-979-4052
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Provider Business Mailing Address
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Address Line | 13136 ALDERLEY DR
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City | ORLANDO
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State | FL
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Zip | 32832-6342
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DN24970
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License Number State | FL
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