Individual
RAFAEL MARTINS AFONSO PEREIRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS, MS
Contact information
Practice address
11512 LAKE MEAD AVE UNIT 532, JACKSONVILLE, FL 32256-9733
(904) 683-4781
Mailing address
11512 LAKE MEAD AVE UNIT 532, JACKSONVILLE, FL 32256-9733
(904) 683-4781
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
DN30764
FL
1223P0300X
Periodontics
Primary
DN30764
FL
Other
Enumeration date
06/07/2023
Last updated
12/17/2025
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