Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0221X | Pediatric Dentist | DN21763 | FL |
NPI | 1023304391 |
---|---|
Provider Name | Dr. Aurelio Antonio Bula |
First Address | Miramar, FL 33027-5425 |
Second Address | Coral Springs, FL 33076 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/06/2011 |
Last Update Date | 03/05/2019 |