Provider Demographics
NPI:1225641749
Name:MARTIN AGUERO, MD PLLC
Entity Type:Organization
Organization Name:MARTIN AGUERO, MD PLLC
Other - Org Name:MARTIN AGUERO, MD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MARTIN
Authorized Official - Middle Name:FRANCISCO
Authorized Official - Last Name:AGUERO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:863-417-7117
Mailing Address - Street 1:25193 ROSAMOND CT
Mailing Address - Street 2:
Mailing Address - City:PUNTA GORDA
Mailing Address - State:FL
Mailing Address - Zip Code:33983-5934
Mailing Address - Country:US
Mailing Address - Phone:939-242-5987
Mailing Address - Fax:
Practice Address - Street 1:3005 CARING WAY STE 3
Practice Address - Street 2:
Practice Address - City:PORT CHARLOTTE
Practice Address - State:FL
Practice Address - Zip Code:33952-5304
Practice Address - Country:US
Practice Address - Phone:863-417-7117
Practice Address - Fax:863-884-1247
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-25
Last Update Date:2023-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty