Provider Demographics
NPI:1235539370
Name:UNIVERSITY OF FLORIDA
Entity Type:Organization
Organization Name:UNIVERSITY OF FLORIDA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTAL RESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROSALIA
Authorized Official - Middle Name:
Authorized Official - Last Name:KOLOKITHAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-394-6064
Mailing Address - Street 1:11759 78TH TER
Mailing Address - Street 2:
Mailing Address - City:SEMINOLE
Mailing Address - State:FL
Mailing Address - Zip Code:33772-4049
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9200 113TH ST
Practice Address - Street 2:
Practice Address - City:SEMINOLE
Practice Address - State:FL
Practice Address - Zip Code:33772-2800
Practice Address - Country:US
Practice Address - Phone:727-394-6064
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-26
Last Update Date:2014-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDRP12761223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty