Provider Demographics
NPI:1598185217
Name:AJURIA, EDUARDO (MD)
Entity Type:Individual
Prefix:
First Name:EDUARDO
Middle Name:
Last Name:AJURIA
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 1:3470 E COAST AVE APT H1511
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33137-3992
Mailing Address - Country:US
Mailing Address - Phone:909-518-0726
Mailing Address - Fax:
Practice Address - Street 1:9655 NW 41ST ST
Practice Address - Street 2:
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33178-2973
Practice Address - Country:US
Practice Address - Phone:305-436-1563
Practice Address - Fax:305-436-1564
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-21
Last Update Date:2023-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA129412208000000X
FLME138115208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL101136900Medicaid