Provider Demographics
NPI:1891818449
Name:PRIEDE, FLORENTINO ANDEW (DDS)
Entity Type:Individual
Prefix:DR
First Name:FLORENTINO
Middle Name:ANDEW
Last Name:PRIEDE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2403 S ARDSON PL
Mailing Address - Street 2:302B
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33629-7346
Mailing Address - Country:US
Mailing Address - Phone:813-251-1913
Mailing Address - Fax:
Practice Address - Street 1:148 WHITAKER RD
Practice Address - Street 2:
Practice Address - City:LUTZ
Practice Address - State:FL
Practice Address - Zip Code:33549-7611
Practice Address - Country:US
Practice Address - Phone:813-949-3211
Practice Address - Fax:813-949-2714
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN21051223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice