Provider Demographics
NPI:1255604591
Name:AURA M. PICON D.D.S., P.A.
Entity type:Organization
Organization Name:AURA M. PICON D.D.S., P.A.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:AURA
Authorized Official - Middle Name:M
Authorized Official - Last Name:PICON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:305-506-1300
Mailing Address - Street 1:13590 SW 134TH AVE
Mailing Address - Street 2:SUITE 112
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-4561
Mailing Address - Country:US
Mailing Address - Phone:305-506-1300
Mailing Address - Fax:305-506-1301
Practice Address - Street 1:13590 SW 134TH AVE
Practice Address - Street 2:SUITE 112
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-4561
Practice Address - Country:US
Practice Address - Phone:305-506-1300
Practice Address - Fax:305-506-1301
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-16
Last Update Date:2012-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN17825261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental