Provider Demographics
NPI:1164621900
Name:AQUININ, RONNY V (MD)
Entity Type:Individual
Prefix:DR
First Name:RONNY
Middle Name:V
Last Name:AQUININ
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 1:4302 ALTON RD
Mailing Address - Street 2:SUITE 470
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33140-2891
Mailing Address - Country:US
Mailing Address - Phone:305-397-8699
Mailing Address - Fax:305-397-8889
Practice Address - Street 1:4302 ALTON RD
Practice Address - Street 2:SUITE 470
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33140-2891
Practice Address - Country:US
Practice Address - Phone:305-397-8699
Practice Address - Fax:305-397-8889
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-12
Last Update Date:2012-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME98088207R00000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLAG411YMedicare UPIN