Provider Demographics
NPI:1033172127
Name:VILARET, MANUEL RICARDO II (DMD)
Entity Type:Individual
Prefix:DR
First Name:MANUEL
Middle Name:RICARDO
Last Name:VILARET
Suffix:II
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:212 7TH AVE N
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33701-2404
Mailing Address - Country:US
Mailing Address - Phone:727-480-1736
Mailing Address - Fax:813-231-1812
Practice Address - Street 1:2010 E HILLSBOROUGH AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33610-8255
Practice Address - Country:US
Practice Address - Phone:813-231-1800
Practice Address - Fax:813-231-1812
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN94971223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice