Provider Demographics
NPI:1518280593
Name:OLIVEIRA-HAAS, LUANA (DDS)
Entity Type:Individual
Prefix:
First Name:LUANA
Middle Name:
Last Name:OLIVEIRA-HAAS
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 1:11980 N BAYPOINT CIR
Mailing Address - Street 2:
Mailing Address - City:PARKLAND
Mailing Address - State:FL
Mailing Address - Zip Code:33076-4847
Mailing Address - Country:US
Mailing Address - Phone:954-696-7718
Mailing Address - Fax:954-696-7718
Practice Address - Street 1:3200 S UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:DAVIE
Practice Address - State:FL
Practice Address - Zip Code:33328-2018
Practice Address - Country:US
Practice Address - Phone:954-262-7213
Practice Address - Fax:954-262-7355
Is Sole Proprietor?:No
Enumeration Date:2010-03-05
Last Update Date:2021-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDRPM2279390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLDTP523OtherLICENSE NUMBER