Provider Demographics
NPI:1184855355
Name:VITTO, ANDREINA C (DDS,MS)
Entity Type:Individual
Prefix:DR
First Name:ANDREINA
Middle Name:C
Last Name:VITTO
Suffix:
Gender:F
Credentials:DDS,MS
Other - Prefix:DR
Other - First Name:ANDREINA
Other - Middle Name:E
Other - Last Name:CASTILLO VITTO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS,MS
Mailing Address - Street 1:1643 BRICKELL AVE APT 1406
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33129-1292
Mailing Address - Country:US
Mailing Address - Phone:305-505-1010
Mailing Address - Fax:
Practice Address - Street 1:2870 NE 8TH ST
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33033-5695
Practice Address - Country:US
Practice Address - Phone:305-547-8398
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-05
Last Update Date:2022-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN256311223P0300X
IN12011399A1223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN1639508609OtherNPI 2-ORG