Provider Demographics
NPI:1912698010
Name:ERBELLA OCANA, RAMON (DMD)
Entity Type:Individual
Prefix:
First Name:RAMON
Middle Name:
Last Name:ERBELLA OCANA
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 1:4516 W MCCOY ST APT 2-320
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33616-1693
Mailing Address - Country:US
Mailing Address - Phone:503-422-2837
Mailing Address - Fax:
Practice Address - Street 1:3863 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33713-8339
Practice Address - Country:US
Practice Address - Phone:727-295-0062
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-18
Last Update Date:2023-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN279261223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice