Provider Demographics
NPI:1679122584
Name:ACUNA, AIDA ELIZABETH
Entity Type:Individual
Prefix:
First Name:AIDA
Middle Name:ELIZABETH
Last Name:ACUNA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20941 BAY CT APT 126
Mailing Address - Street 2:
Mailing Address - City:AVENTURA
Mailing Address - State:FL
Mailing Address - Zip Code:33180-3726
Mailing Address - Country:US
Mailing Address - Phone:786-877-0651
Mailing Address - Fax:
Practice Address - Street 1:20941 BAY CT APT 126
Practice Address - Street 2:
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33180-3726
Practice Address - Country:US
Practice Address - Phone:786-877-0651
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-04
Last Update Date:2019-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11001198363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily