Provider Demographics
NPI:1801230768
Name:STREETT, ROSARIO DEL PILAR (DDS)
Entity type:Individual
Prefix:
First Name:ROSARIO
Middle Name:DEL PILAR
Last Name:STREETT
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3800 N UNIVERSITY DR UNIT 203
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33024-2241
Mailing Address - Country:US
Mailing Address - Phone:754-296-3800
Mailing Address - Fax:
Practice Address - Street 1:3800 N UNIVERSITY DR UNIT 203
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33024-2241
Practice Address - Country:US
Practice Address - Phone:754-296-3800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-23
Last Update Date:2023-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
FLDN21495122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program