Provider Demographics
NPI:1003051533
Name:RONNY AQUININ MD PA
Entity Type:Organization
Organization Name:RONNY AQUININ MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:RONNY
Authorized Official - Middle Name:
Authorized Official - Last Name:AQUININ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-495-1052
Mailing Address - Street 1:10093 BAY HARBOR TERRACE
Mailing Address - Street 2:
Mailing Address - City:BAY HARBOR ISLANDS
Mailing Address - State:FL
Mailing Address - Zip Code:33154-1509
Mailing Address - Country:US
Mailing Address - Phone:305-495-1052
Mailing Address - Fax:
Practice Address - Street 1:10093 BAY HARBOR TERRACE
Practice Address - Street 2:
Practice Address - City:BAY HARBOR ISLANDS
Practice Address - State:FL
Practice Address - Zip Code:33154-1509
Practice Address - Country:US
Practice Address - Phone:305-495-1052
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-12
Last Update Date:2009-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME98088207R00000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL278922100Medicaid
FL278922100Medicaid