Provider Demographics
NPI:1841337052
Name:ALEDO, FRED J (DMD)
Entity type:Individual
Prefix:DR
First Name:FRED
Middle Name:J
Last Name:ALEDO
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 1:12919 ROYAL GEORGE AVE
Mailing Address - Street 2:
Mailing Address - City:ODESSA
Mailing Address - State:FL
Mailing Address - Zip Code:33556-5710
Mailing Address - Country:US
Mailing Address - Phone:813-205-7412
Mailing Address - Fax:
Practice Address - Street 1:7002 GUNN HWY STE 3
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33625
Practice Address - Country:US
Practice Address - Phone:813-448-2239
Practice Address - Fax:813-926-9135
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN181621223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice