Provider Demographics
NPI:1386218444
Name:AGUIRRE, LUIS ANGEL (MRC)
Entity Type:Individual
Prefix:MR
First Name:LUIS
Middle Name:ANGEL
Last Name:AGUIRRE
Suffix:
Gender:M
Credentials:MRC
Other - Prefix:MR
Other - First Name:LUIS
Other - Middle Name:ANGEL
Other - Last Name:AGUIRRE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MRC
Mailing Address - Street 1:PO BOX 947
Mailing Address - Street 2:
Mailing Address - City:SANTA ISABEL
Mailing Address - State:PR
Mailing Address - Zip Code:00757-0947
Mailing Address - Country:US
Mailing Address - Phone:787-597-6294
Mailing Address - Fax:
Practice Address - Street 1:URB ROLLING HILLS B-48
Practice Address - Street 2:
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00987
Practice Address - Country:US
Practice Address - Phone:787-597-6294
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-13
Last Update Date:2021-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1727225C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225C00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Counselor