Provider Demographics
NPI:1629671581
Name:RABASSA OLAZABAL, YUDIT DE LA CARIDAD (CRDH)
Entity Type:Individual
Prefix:
First Name:YUDIT
Middle Name:DE LA CARIDAD
Last Name:RABASSA OLAZABAL
Suffix:
Gender:F
Credentials:CRDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5285 RED BUG LAKE RD STE 105
Mailing Address - Street 2:
Mailing Address - City:WINTER SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32708-4973
Mailing Address - Country:US
Mailing Address - Phone:407-696-4474
Mailing Address - Fax:407-696-1001
Practice Address - Street 1:5285 RED BUG LAKE RD STE 105
Practice Address - Street 2:
Practice Address - City:WINTER SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32708-4973
Practice Address - Country:US
Practice Address - Phone:407-696-4474
Practice Address - Fax:407-696-1001
Is Sole Proprietor?:No
Enumeration Date:2020-11-20
Last Update Date:2020-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDH24469124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist