Provider Demographics
NPI:1376195214
Name:PEREZ CASTRO, AYMET (DMD)
Entity Type:Individual
Prefix:
First Name:AYMET
Middle Name:
Last Name:PEREZ CASTRO
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8463 NW 107TH PATH UNIT 1
Mailing Address - Street 2:
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33178-5234
Mailing Address - Country:US
Mailing Address - Phone:786-468-4209
Mailing Address - Fax:
Practice Address - Street 1:167 W 23RD ST
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33010-2211
Practice Address - Country:US
Practice Address - Phone:305-889-3121
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-11
Last Update Date:2022-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL265191223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice