Provider Demographics
NPI:1194566448
Name:CAMPANO DEVARONA, ABEL E (DMD)
Entity type:Individual
Prefix:DR
First Name:ABEL
Middle Name:E
Last Name:CAMPANO DEVARONA
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 1:1305 MORGAN STANLEY AVE UNIT 416
Mailing Address - Street 2:
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32789-1964
Mailing Address - Country:US
Mailing Address - Phone:551-999-1307
Mailing Address - Fax:
Practice Address - Street 1:851 S STATE ROAD 434 STE 1040
Practice Address - Street 2:
Practice Address - City:ALTAMONTE SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32714-4812
Practice Address - Country:US
Practice Address - Phone:407-603-2344
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-03
Last Update Date:2024-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN28985122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist