MEDICARE: LILIBETH AYANGCO DMD PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	DN15095	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	V15095	OTHER	FL	BCBS

General Provider Information

NPI Number	:	1043328453
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LILIBETH AYANGCO DMD PA

Provider Business Mailing Address
First Line	:	1500 E HILLSBORO BLVD
Second Line	:	#101
City	:	DEERFIELD BCH
State	:	FL
Zip	:	33441
Country	:	US
Telephone Number	:	954-427-5700
Fax Number	:	954-427-5990

Provider Business Practice Location Address
First Line	:	1500 E HILLSBORO BLVD
Second Line	:	#101
City	:	DEERFIELD BCH
State	:	FL
Zip	:	33441
Country	:	US
Telephone Number	:	954-427-5700
Fax Number	:	954-427-5990

Authorized Official
Title or Position	:	DOCTOR OWNER
Name	:	DR. LILIBETH AYANGCO
Credential	:	DMD MS
Telephone Number	:	954-427-5700

Provider Enumeration Date	:	08/26/2006
Last Update Date	:	01/24/2012

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