Provider Demographics
NPI:1073931002
Name:AGUILERA, ONEIDA (BS)
Entity Type:Individual
Prefix:
First Name:ONEIDA
Middle Name:
Last Name:AGUILERA
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:175 FONTAINEBLEAU BLVD
Mailing Address - Street 2:SUITE 2M7
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33172-7018
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:175 FONTAINEBLEAU BLVD
Practice Address - Street 2:SUITE 2M7
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33172-7018
Practice Address - Country:US
Practice Address - Phone:786-285-6530
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-07
Last Update Date:2016-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator