Individual
DR. JULIO MARIO CERVANTES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1344 22ND ST S, ST PETERSBURG, FL 33712-2744
(727) 284-8181
Mailing address
14100 58TH ST N, CLEARWATER, FL 33760-9900
(727) 824-8181
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
25906
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
116698600
—
FL
01
—
QD878
MEDICARE
FL
Enumeration date
06/28/2021
Last updated
08/13/2024
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