Provider Demographics
NPI:1205087897
Name:AMADOR, FABRIZIO KENNETH (DMD)
Entity type:Individual
Prefix:MR
First Name:FABRIZIO
Middle Name:KENNETH
Last Name:AMADOR
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 NORTH FEDERAL HIGHWAY #300
Mailing Address - Street 2:
Mailing Address - City:POMPANO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33062
Mailing Address - Country:US
Mailing Address - Phone:954-941-4410
Mailing Address - Fax:954-987-0145
Practice Address - Street 1:2000 NORTH FEDERAL HIGHWAY #300
Practice Address - Street 2:
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33062
Practice Address - Country:US
Practice Address - Phone:954-941-4410
Practice Address - Fax:954-987-0145
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-01
Last Update Date:2016-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN 18363122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist