Provider Demographics
NPI:1316308547
Name:RENATO J. AVES, LLC
Entity type:Organization
Organization Name:RENATO J. AVES, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RENATO
Authorized Official - Middle Name:J
Authorized Official - Last Name:AVES
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:813-885-6555
Mailing Address - Street 1:7720 W WATERS AVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33615-1813
Mailing Address - Country:US
Mailing Address - Phone:813-885-6555
Mailing Address - Fax:813-882-8018
Practice Address - Street 1:7720 W WATERS AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33615-1813
Practice Address - Country:US
Practice Address - Phone:813-885-6555
Practice Address - Fax:813-882-8018
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-16
Last Update Date:2024-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty