Provider Demographics
NPI:1871841379
Name:JARAMILLO RIVAS, AYMEE (DDS)
Entity Type:Individual
Prefix:DR
First Name:AYMEE
Middle Name:
Last Name:JARAMILLO RIVAS
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 1:4621 SUNBEAM STATION CT
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32257-5281
Mailing Address - Country:US
Mailing Address - Phone:626-488-6546
Mailing Address - Fax:904-503-7944
Practice Address - Street 1:9776 SAN JOSE BLVD STE 1
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32257-5464
Practice Address - Country:US
Practice Address - Phone:904-475-2177
Practice Address - Fax:904-503-7944
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-15
Last Update Date:2017-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN20454122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist