MEDICARE: AIMARA CORINA VILLALOBOS

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	126800000X	Dental Assistant	DR138181	FL

General Provider Information

NPI Number	:	1639889835
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AIMARA CORINA VILLALOBOS

Provider Business Mailing Address
First Line	:	1440 NW NORTH RIVER DR STE 345
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33125-2894
Country	:	US
Telephone Number	:	786-353-9887
Fax Number	:	786-320-6281

Provider Business Practice Location Address
First Line	:	1440 NW NORTH RIVER DR STE 345
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33125-2894
Country	:	US
Telephone Number	:	786-353-9887
Fax Number	:	786-320-6281

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

Provider Enumeration Date	:	11/29/2022
Last Update Date	:	11/29/2022

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Directions to “ AIMARA CORINA VILLALOBOS ” Practice Location

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