Provider Demographics
NPI:1043276249
Name:ARAGON, ROMUALDO ARAGON JR (MD)
Entity Type:Individual
Prefix:
First Name:ROMUALDO
Middle Name:ARAGON
Last Name:ARAGON
Suffix:JR
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 1:1641 E FLAMINGO RD STE 11
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89119-5257
Mailing Address - Country:US
Mailing Address - Phone:702-737-9520
Mailing Address - Fax:702-737-9522
Practice Address - Street 1:1641 E FLAMINGO RD STE 11
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89119-5257
Practice Address - Country:US
Practice Address - Phone:702-737-9520
Practice Address - Fax:702-737-9522
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-25
Last Update Date:2020-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV9214207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV2018352Medicaid
NV2018352Medicaid
NVF96107Medicare UPIN