Provider Demographics
NPI:1003302290
Name:AGUERO, MARTIN FRANCISCO (MD)
Entity Type:Individual
Prefix:DR
First Name:MARTIN
Middle Name:FRANCISCO
Last Name:AGUERO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24013 MADACA LN UNIT 104
Mailing Address - Street 2:
Mailing Address - City:PORT CHARLOTTE
Mailing Address - State:FL
Mailing Address - Zip Code:33954-2807
Mailing Address - Country:US
Mailing Address - Phone:939-242-5987
Mailing Address - Fax:863-884-1247
Practice Address - Street 1:18700 VETERANS BLVD UNIT 9
Practice Address - Street 2:
Practice Address - City:PORT CHARLOTTE
Practice Address - State:FL
Practice Address - Zip Code:33954-1037
Practice Address - Country:US
Practice Address - Phone:941-263-1776
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-10
Last Update Date:2020-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR21056208D00000X
FLACN1219208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice