Provider Demographics
NPI:1144467168
Name:PEDRO, JAMILY (DMD)
Entity type:Individual
Prefix:DR
First Name:JAMILY
Middle Name:
Last Name:PEDRO
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:JAMILY
Other - Middle Name:
Other - Last Name:PEDRO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:7050 W PALMETTO PARK RD STE 52
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33433-3464
Mailing Address - Country:US
Mailing Address - Phone:561-394-2592
Mailing Address - Fax:
Practice Address - Street 1:7050 W PALMETTO PARK RD STE 52
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33433-3464
Practice Address - Country:US
Practice Address - Phone:561-394-2592
Practice Address - Fax:561-394-3768
Is Sole Proprietor?:No
Enumeration Date:2009-01-13
Last Update Date:2017-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10274122300000X
FLDN19518122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist