Provider Demographics
NPI:1467091694
Name:ARAGON, ADRIANNA CAROLINA
Entity Type:Individual
Prefix:MRS
First Name:ADRIANNA
Middle Name:CAROLINA
Last Name:ARAGON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ADRIANNA
Other - Middle Name:CAROLINA
Other - Last Name:DIAZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:14250 SW 68TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33183-2150
Mailing Address - Country:US
Mailing Address - Phone:305-903-0095
Mailing Address - Fax:
Practice Address - Street 1:14250 SW 68TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33183-2150
Practice Address - Country:US
Practice Address - Phone:305-903-0095
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-06
Last Update Date:2020-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11005597363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner