Provider Demographics
NPI:1225927023
Name:DICKINSON AVILES, CARLOTA MICHELLE (OD)
Entity type:Individual
Prefix:DR
First Name:CARLOTA
Middle Name:MICHELLE
Last Name:DICKINSON AVILES
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 NW 190TH AVE FL 33029
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33029-2907
Mailing Address - Country:US
Mailing Address - Phone:661-623-1098
Mailing Address - Fax:
Practice Address - Street 1:7800 W 33RD AVE STE 1
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33018-5071
Practice Address - Country:US
Practice Address - Phone:786-515-2017
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-28
Last Update Date:2025-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL6665152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist