Provider Demographics
NPI:1366998080
Name:CICORTAS, FLORIN NICOLAE (DMD)
Entity type:Individual
Prefix:DR
First Name:FLORIN
Middle Name:NICOLAE
Last Name:CICORTAS
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5701 SW 24TH AVE
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33312
Mailing Address - Country:US
Mailing Address - Phone:954-830-0425
Mailing Address - Fax:
Practice Address - Street 1:9101 LAKERIDGE BLVD STE 9
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33496-2147
Practice Address - Country:US
Practice Address - Phone:561-852-7700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-01
Last Update Date:2020-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN221471223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice