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General NPI Number Information
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NPI Number | 1639944648
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Entity Type | Individual
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Provider Name | RODOLPHO LUVISON COSTA GUIMARAES DDS
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Gender | Male
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Dates
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Enumeration Date | 11/20/2023
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Last Update Date | 12/24/2025
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Provider Practice Location Address
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Address Line | 3801 PARK ST N SUITE 1
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City | SAINT PETERSBURG
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State | FL
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Zip | 33709
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Country | US
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Telephone | 727-440-6488
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Fax |
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Provider Business Mailing Address
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Address Line | 3801 PARK ST N SUITE 1
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City | SAINT PETERSBURG
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State | FL
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Zip | 33709
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Country | US
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Telephone | 727-440-6488
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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 | DN31157
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | NO.RES.004696
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License Number State | OH
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