Individual
CARLOS MANUEL ANICETO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5285 RED BUG LAKE RD STE 105, WINTER SPRINGS, FL 32708-4973
(407) 696-4474
(407) 696-1001
Mailing address
983 BENNETT RD APT 201, ORLANDO, FL 32814-6092
(786) 662-9648
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN26160
FL
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
03/11/2019
Last updated
11/12/2021
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