1285157826 NPI number — DR. PAULO ARTUR OLIVEIRA DDS

Table of content: DR. PAULO ARTUR OLIVEIRA DDS (NPI 1285157826)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1285157826 NPI number — DR. PAULO ARTUR OLIVEIRA DDS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
OLIVEIRA
Provider First Name:
PAULO
Provider Middle Name:
ARTUR
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DDS
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
SALDANHA DE MENEZES OLIVEIRA
Provider Other First Name:
PAULO
Provider Other Middle Name:
ARTUR
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
DDS
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1285157826
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/01/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1700 NW 49TH ST STE 125
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FORT LAUDERDALE
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33309-3750
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
954-728-8080
Provider Business Mailing Address Fax Number:
954-779-1957

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1401 S FEDERAL HWY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FORT LAUDERDALE
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33316-2619
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
954-728-8080
Provider Business Practice Location Address Fax Number:
954-779-1957
Provider Enumeration Date:
07/25/2017

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1223G0001X , with the licence number:  DN22922 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 100388300 . This is a "Florida Medicaid Provider ID" identifier , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




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