Provider Demographics
NPI:1528707882
Name:BRANDAO, PATRICIA O (DMD)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:O
Last Name:BRANDAO
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:315 SE MIZNER BLVD
Mailing Address - Street 2:SUITE 216
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33432-3327
Mailing Address - Country:US
Mailing Address - Phone:561-338-5005
Mailing Address - Fax:561-576-3028
Practice Address - Street 1:315 SE MIZNER BLVD STE 216
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33432-6086
Practice Address - Country:US
Practice Address - Phone:561-338-5005
Practice Address - Fax:561-576-3028
Is Sole Proprietor?:No
Enumeration Date:2022-06-03
Last Update Date:2023-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN26865122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist