Kaitria Brielle Abbatematteo, D.M.D.
Individual provider Active NPI Dentist · Gainesville, FL
NPI 1083458293 · NPPES record last updated Jun 21, 2024
Key facts
- NPI
- 1083458293
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- DRPM2762 (FL)
- Practice address
- 1395 Center Dr RM D1-40
Gainesville, FL 32610-3006 - Phone
- (352) 273-7643
- NPI assigned
- Jun 21, 2024
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DRPM2762 | FL | MD | Dentist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DRPM2762 | FL | Yes |
Addresses
Primary practice location
1395 Center Dr RM D1-40
Gainesville, FL 32610-3006
Mailing address
2337 SW Archer Rd Apt 1003
Gainesville, FL 32608-1008
Phone (941) 204-1486
Other providers in Gainesville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 21, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.