Provider Demographics
NPI:1407129828
Name:VILCHES, AMAURY (MT)
Entity Type:Individual
Prefix:
First Name:AMAURY
Middle Name:
Last Name:VILCHES
Suffix:
Gender:M
Credentials:MT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:356 ALHAMBRA CIR
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-5004
Mailing Address - Country:US
Mailing Address - Phone:305-445-0477
Mailing Address - Fax:305-445-0958
Practice Address - Street 1:356 ALHAMBRA CIR
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-5004
Practice Address - Country:US
Practice Address - Phone:305-445-0477
Practice Address - Fax:305-445-0958
Is Sole Proprietor?:No
Enumeration Date:2012-02-15
Last Update Date:2012-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA65414225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist