Provider Demographics
NPI:1376172940
Name:ALMEIDA REGUEIRO, YASEL
Entity Type:Individual
Prefix:
First Name:YASEL
Middle Name:
Last Name:ALMEIDA REGUEIRO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4317 WATERFORD LANDING DR
Mailing Address - Street 2:
Mailing Address - City:LUTZ
Mailing Address - State:FL
Mailing Address - Zip Code:33558-9727
Mailing Address - Country:US
Mailing Address - Phone:813-401-7577
Mailing Address - Fax:
Practice Address - Street 1:1180 MARINER BLVD
Practice Address - Street 2:
Practice Address - City:SPRING HILL
Practice Address - State:FL
Practice Address - Zip Code:34609-5603
Practice Address - Country:US
Practice Address - Phone:352-204-1254
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-06
Last Update Date:2023-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN27306122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist