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NPI Code Detail

MEDICARE: ANTHONY JOHN DENAVARRA D.M.D.

MEDICARE:   ANTHONY JOHN DENAVARRA  D.M.D.
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
11223G0001XGeneral Practice DentistryDN12308FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
169082OTHERFLPROVIDER
291305OTHERFLDELTA DENTAL

General Provider Information

NPI Number : 1831301506
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANTHONY JOHN DENAVARRA D.M.D.
Provider Business Mailing Address
First Line : 224 PASADENA AVE S
Second Line :
City : SAINT PETERSBURG
State : FL
Zip : 33707-1251
Country : US
Telephone Number : 727-347-4392
Fax Number : 727-347-6055
Provider Business Practice Location Address
First Line : 224 PASADENA AVE S
Second Line :
City : SAINT PETERSBURG
State : FL
Zip : 33707-1251
Country : US
Telephone Number : 727-347-4392
Fax Number : 727-347-6055
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/04/2007
Last Update Date : 07/08/2007

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Directions to “ ANTHONY JOHN DENAVARRA D.M.D.” Practice Location

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