Provider Demographics
NPI:1871789701
Name:RAVAZZI, LUCIANA E (DDS)
Entity type:Individual
Prefix:DR
First Name:LUCIANA
Middle Name:E
Last Name:RAVAZZI
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2600 SW 27TH AVE
Mailing Address - Street 2:APT. 505
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33133-3001
Mailing Address - Country:US
Mailing Address - Phone:305-446-5935
Mailing Address - Fax:305-857-9180
Practice Address - Street 1:2601 S BAYSHORE DR
Practice Address - Street 2:SUITE 760
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33133
Practice Address - Country:US
Practice Address - Phone:305-857-0990
Practice Address - Fax:305-857-9180
Is Sole Proprietor?:No
Enumeration Date:2007-09-25
Last Update Date:2007-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN18149122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist