Provider Demographics
NPI:1942457692
Name:AYMERICH, ENRIQUE (MD)
Entity Type:Individual
Prefix:
First Name:ENRIQUE
Middle Name:
Last Name:AYMERICH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2224 SW 16TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33145-3926
Mailing Address - Country:US
Mailing Address - Phone:305-299-9427
Mailing Address - Fax:
Practice Address - Street 1:1149 SW 27TH AVE
Practice Address - Street 2:2ND FLOOR.
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33135-4758
Practice Address - Country:US
Practice Address - Phone:305-642-1588
Practice Address - Fax:305-642-1585
Is Sole Proprietor?:No
Enumeration Date:2008-08-25
Last Update Date:2014-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME102602207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL001261000Medicaid
FL145WCOtherBC/BS
FLBG185YOtherMEDICARE PTAN
FL145WCOtherBC/BS