Organization
ACTIVE CARE ENDODONTICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. J. MAURICIO GIRALDO (OWNER/PRESIDENT)
(813) 662-9282
Entity
Organization
Contact information
Practice address
1745 S KINGS AVE, BRANDON, FL 33511-6220
(813) 662-9282
Mailing address
1745 S KINGS AVE, BRANDON, FL 33511-6220
(813) 662-9282
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
DN0013539
FL
Other
Enumeration date
01/17/2017
Last updated
01/17/2017
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