Provider Demographics
NPI:1407419229
Name:BUZZI, NICOLE CRISTINE (DMD)
Entity Type:Individual
Prefix:DR
First Name:NICOLE
Middle Name:CRISTINE
Last Name:BUZZI
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 1:1440 NW N RVR DR STE 345
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33125-2894
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1440 NW N RVR DR STE 345
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33125-2894
Practice Address - Country:US
Practice Address - Phone:786-638-2110
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-17
Last Update Date:2023-10-04
Deactivation Date:2019-04-17
Deactivation Code:
Reactivation Date:2019-07-17
Provider Licenses
StateLicense IDTaxonomies
FLD246401223P0221X
FLDN24640122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Yes1223P0221XDental ProvidersDentistPediatric Dentistry