Provider Demographics
NPI:1508410499
Name:CIRION MOREJON, AYLEEN (DOCTOR OF STOMATOLOG)
Entity Type:Individual
Prefix:
First Name:AYLEEN
Middle Name:
Last Name:CIRION MOREJON
Suffix:
Gender:F
Credentials:DOCTOR OF STOMATOLOG
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16879 NW 67TH AVE
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33015-4203
Mailing Address - Country:US
Mailing Address - Phone:786-551-9031
Mailing Address - Fax:
Practice Address - Street 1:16879 NW 67TH AVE
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33015-4203
Practice Address - Country:US
Practice Address - Phone:786-551-9031
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-29
Last Update Date:2019-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN244861223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty