Provider Demographics
NPI:1457687618
Name:BOZZUTI, GABRIELA ALEJANDRA (DDS)
Entity Type:Individual
Prefix:DR
First Name:GABRIELA
Middle Name:ALEJANDRA
Last Name:BOZZUTI
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1409 BANYAN WAY
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:FL
Mailing Address - Zip Code:33327-1622
Mailing Address - Country:US
Mailing Address - Phone:954-349-2183
Mailing Address - Fax:
Practice Address - Street 1:2751 EXECUTIVE PARK DR
Practice Address - Street 2:SUITE 204
Practice Address - City:WESTON
Practice Address - State:FL
Practice Address - Zip Code:33331-3660
Practice Address - Country:US
Practice Address - Phone:954-706-6440
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-23
Last Update Date:2016-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL188051223P0700X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics
No1223G0001XDental ProvidersDentistGeneral Practice