Provider Demographics
NPI:1629238407
Name:CORREA-PINTO, RAFAELLA BAPTISTA (DMD)
Entity Type:Individual
Prefix:DR
First Name:RAFAELLA
Middle Name:BAPTISTA
Last Name:CORREA-PINTO
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 1:1901 N FEDERAL HWY
Mailing Address - Street 2:SUITE 215
Mailing Address - City:POMPANO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33062-1000
Mailing Address - Country:US
Mailing Address - Phone:954-785-1102
Mailing Address - Fax:954-785-1344
Practice Address - Street 1:1901 N FEDERAL HWY
Practice Address - Street 2:SUITE 215
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33062-1000
Practice Address - Country:US
Practice Address - Phone:954-785-1102
Practice Address - Fax:954-785-1344
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-14
Last Update Date:2015-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN183231223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice