Provider Demographics
NPI:1164080495
Name:BRANDAO, PAMELA OLIVEIRA (DMD)
Entity Type:Individual
Prefix:DR
First Name:PAMELA
Middle Name:OLIVEIRA
Last Name:BRANDAO
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2100 LAKE IDA RD STE 2A
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33445-2442
Mailing Address - Country:US
Mailing Address - Phone:561-272-2131
Mailing Address - Fax:
Practice Address - Street 1:2100 LAKE IDA RD STE 2A
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33445-2442
Practice Address - Country:US
Practice Address - Phone:561-272-2131
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-02
Last Update Date:2023-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN241331223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice