Individual
DR. JUAN CARLOS ORTIZ CEDENO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
3970 SW 24TH AVE, GAINESVILLE, FL 32607-4485
(585) 448-5603
Mailing address
3970 SW 24TH AVE APT 414, GAINESVILLE, FL 32607-4489
(585) 448-5603
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN27160
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0632423771340
DRIVER LICENSE
FL
Enumeration date
06/28/2022
Last updated
06/28/2022
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