Rene J Aviles, DMD

Individual provider Active NPI General Practice Dentistry · Palm City, FL

NPI 1619081114 · NPPES record last updated Sep 9, 2011

Key facts

NPI
1619081114
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
DN14524 (FL)
Practice address
870 SW Martin Downs Blvd Ste 1
Palm City, FL 34990-2855
Phone
(772) 283-6881
Fax
(772) 283-6362
NPI assigned
Aug 19, 2006
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
DN14524FLMDGeneral Practice Dentistry

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DN14524 FL Yes

Addresses

Primary practice location

870 SW Martin Downs Blvd Ste 1
Palm City, FL 34990-2855

Mailing address

870 SW Martin Downs Blvd Ste 1
Palm City, FL 34990-2855
Phone (772) 283-6881

Other providers in Palm City, FL

All providers in Palm City, FL · General Practice Dentistry in Florida

Sources for this page

Verify at the official NPI Registry.