MEDICARE: DR. REGINALD HORACE CARDOZO DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	0013582	FL

General Provider Information

NPI Number	:	1497752315
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. REGINALD HORACE CARDOZO DDS

Provider Business Mailing Address
First Line	:	7301A W PALMETTO PARK RD
Second Line	:	#203-A
City	:	BOCA RATON
State	:	FL
Zip	:	33433-3409
Country	:	US
Telephone Number	:	561-362-8308
Fax Number	:	561-362-7654

Provider Business Practice Location Address
First Line	:	7301A W PALMETTO PARK RD
Second Line	:	#203-A
City	:	BOCA RATON
State	:	FL
Zip	:	33433-3409
Country	:	US
Telephone Number	:	561-362-8308
Fax Number	:	561-362-7654

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/07/2005
Last Update Date	:	01/13/2010

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