Organization
GUAVA DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LESLIE LYNETTE NEVAREZ GONZALEZ DMD (OWNER)
(813) 773-3601
Entity
Organization
Contact information
Practice address
10672 BLOOMINGDALE AVE UNIT 102, RIVERVIEW, FL 33578-4291
(813) 773-3601
Mailing address
10672 BLOOMINGDALE AVE UNIT 102, RIVERVIEW, FL 33578-4291
(813) 773-3601
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
05/13/2024
Last updated
05/13/2024
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