Provider Demographics
NPI:1497877716
Name:CAYIA, AGATHA M (DMD)
Entity Type:Individual
Prefix:DR
First Name:AGATHA
Middle Name:M
Last Name:CAYIA
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 1:16850 S US HIGHWAY 441
Mailing Address - Street 2:SUITE 301
Mailing Address - City:SUMMERFIELD
Mailing Address - State:FL
Mailing Address - Zip Code:34491-8660
Mailing Address - Country:US
Mailing Address - Phone:352-307-3006
Mailing Address - Fax:352-307-2070
Practice Address - Street 1:16850 S US HIGHWAY 441
Practice Address - Street 2:SUITE 301
Practice Address - City:SUMMERFIELD
Practice Address - State:FL
Practice Address - Zip Code:34491-8660
Practice Address - Country:US
Practice Address - Phone:352-307-3006
Practice Address - Fax:352-307-2070
Is Sole Proprietor?:No
Enumeration Date:2007-04-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN100061223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice