Healthcare Provider Details

I. General information

NPI: 1285298307
Provider Name (Legal Business Name): AASITH VILLAVICENCIO PAZ M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/24/2019
Last Update Date: 03/17/2025
Certification Date: 03/17/2025
Deactivation Date: 12/09/2019
Reactivation Date: 12/16/2019

III. Provider practice location address

1611 NW 12TH AVENUE SUITE CENTRAL 600-D
MIAMI FL
33136
US

IV. Provider business mailing address

1611 NW 12TH AVENUE SUITE CENTRAL 600-D
MIAMI FL
33136
US

V. Phone/Fax

Practice location:
  • Phone: 305-585-5215
  • Fax: 305-585-8137
Mailing address:
  • Phone: 305-585-5215
  • Fax: 305-585-8137

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License NumberME0169837
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: