Active NPI
Otmara Garcia Perez de Villa Amil
- Dentist
- Miami, FL
National Provider Identifier
1376378182
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 29617
- Practice address
- 6724 SW 114TH PL Apt D
Miami, FL 33173-4728 - Phone
- (786) 672-9436
- NPI assigned
- Sep 3, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 29617 | FL | Primary |
Addresses
Primary practice location
6724 SW 114TH PL Apt D
Miami, FL 33173-4728
Mailing address
6724 SW 114TH PL Apt D
Miami, FL 33173-4728
Phone (786) 672-9436
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250807003663 | FL | Order and Referring Only - Dentist | 6406354661 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 29617 | FL | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1725321600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1733443200000",
"number": "1376378182",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6724 SW 114TH PL APT D",
"city": "MIAMI",
"state": "FL",
"postal_code": "331734728",
"telephone_number": "786-672-9436"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6724 SW 114TH PL APT D",
"city": "MIAMI",
"state": "FL",
"postal_code": "331734728",
"telephone_number": "786-672-9436"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GARCIA PEREZ DE VILLA AMIL",
"first_name": "OTMARA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-09-03",
"last_updated": "2024-12-06",
"certification_date": "2024-12-06",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "FL",
"license": "29617",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Miami, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.