MEDICARE: AYMEE ALMAGUER BEZANILLA DDS

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	1223G0001X	General Practice Dentistry	22415	FL
2	122300000X	Dentist	058974	NY
3	122300000X	Dentist	22415	FL

General Provider Information

NPI Number	:	1588000814
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AYMEE ALMAGUER BEZANILLA DDS

Provider Business Mailing Address
First Line	:	295 MONROE AVE
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14607-3660
Country	:	US
Telephone Number	:	585-467-4513
Fax Number	:	585-467-4665

Provider Business Practice Location Address
First Line	:	11116 US HIGHWAY 19
Second Line	:
City	:	PORT RICHEY
State	:	FL
Zip	:	34668-2249
Country	:	US
Telephone Number	:	727-869-1200
Fax Number	:	727-310-2937

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/14/2013
Last Update Date	:	07/21/2022

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