MEDICARE: SOUTH FAMILIA DENTAL PA

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	261QD0000X	Dental Clinic/Center	DN19152	FL

General Provider Information

NPI Number	:	1871043018
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOUTH FAMILIA DENTAL PA

Provider Business Mailing Address
First Line	:	12720 S ORANGE BLOSSOM TRL
Second Line	:	STE 22
City	:	ORLANDO
State	:	FL
Zip	:	32837-6225
Country	:	US
Telephone Number	:	407-240-2255
Fax Number	:

Provider Business Practice Location Address
First Line	:	12720 S ORANGE BLOSSOM TRL
Second Line	:	STE 22
City	:	ORLANDO
State	:	FL
Zip	:	32837-6225
Country	:	US
Telephone Number	:	407-240-2255
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. GABRIEL JOSHUA SANGALANG
Credential	:	DMD
Telephone Number	:	407-240-2255

Provider Enumeration Date	:	10/12/2016
Last Update Date	:	10/12/2016

Similar Medicare Providers

1588777650 — DR. JAMIE REITER D.D.S.
Practice Location Address:

12720 S ORANGE BLOSSOM TRL , # 22
ORLANDO, FL
32837-6225

Practice Phone: 407-240-2255
Practice Fax:

1851453344 — JERROD PRESCOT WILSON D.C.
Practice Location Address:

12720 S ORANGE BLOSSOM TRL , # 20
ORLANDO, FL
32837-6225

Practice Phone: 407-438-4888
Practice Fax: 407-398-0117

1215539333 — TEISHA NICOLE PACK LCSW
Practice Location Address:

6225 BENT PINE DR APT 420A
ORLANDO, FL
32822-4934

Practice Phone: 407-425-6204
Practice Fax: 407-542-6204

1144086497 — UCHENNA MAURICE CHUDE
Practice Location Address:

7532 AZALEA COVE CIR
ORLANDO, FL
32807-6225

Practice Phone: 407-453-1216
Practice Fax: 305-306-2184

1518906452 — PUBLIX SUPER MARKETS INC
Practice Location Address:

3972 TOWN CTR BLVD
ORLANDO, FL
32837-6103

Practice Phone: 407-850-4361
Practice Fax: 407-438-9764

1265473763 — PUBLIX SUPER MARKETS INC
Practice Location Address:

12195 ORANGE BLOSSOM TRAIL
ORLANDO, FL
32837-6502

Practice Phone: 407-816-4233
Practice Fax: 407-816-9651

Directions to “SOUTH FAMILIA DENTAL PA ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.