Provider Demographics
NPI:1700352192
Name:FARINA ORTHODONTIC SPECIALISTS
Entity Type:Organization
Organization Name:FARINA ORTHODONTIC SPECIALISTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:FARINA
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:813-972-2929
Mailing Address - Street 1:2370 BRUCE B DOWNS BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:WESLEY CHAPEL
Mailing Address - State:FL
Mailing Address - Zip Code:33544-9214
Mailing Address - Country:US
Mailing Address - Phone:813-972-2929
Mailing Address - Fax:813-994-6464
Practice Address - Street 1:2370 BRUCE B DOWNS BLVD STE A
Practice Address - Street 2:
Practice Address - City:WESLEY CHAPEL
Practice Address - State:FL
Practice Address - Zip Code:33544-9214
Practice Address - Country:US
Practice Address - Phone:813-972-2929
Practice Address - Fax:813-994-6464
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-23
Last Update Date:2018-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Multi-Specialty