Provider Demographics
NPI:1376806125
Name:RODRIGUEZ CASTRO, LILIAM (DDS)
Entity Type:Individual
Prefix:
First Name:LILIAM
Middle Name:
Last Name:RODRIGUEZ CASTRO
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 1:8020 SW 13TH TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33144-5222
Mailing Address - Country:US
Mailing Address - Phone:786-260-8152
Mailing Address - Fax:
Practice Address - Street 1:8020 SW 13TH TER
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33144-5222
Practice Address - Country:US
Practice Address - Phone:786-260-8152
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-18
Last Update Date:2013-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN 197651223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice