Provider Demographics
NPI:1679125686
Name:AGUILAR, RODOLFO ANTONIO (PMHNP-BC)
Entity Type:Individual
Prefix:DR
First Name:RODOLFO
Middle Name:ANTONIO
Last Name:AGUILAR
Suffix:
Gender:M
Credentials:PMHNP-BC
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Mailing Address - Street 1:18291 N PIMA RD STE 110-330
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85255-5697
Mailing Address - Country:US
Mailing Address - Phone:480-702-1420
Mailing Address - Fax:480-718-7720
Practice Address - Street 1:7272 E INDIAN SCHOOL RD STE 540
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85251-3996
Practice Address - Country:US
Practice Address - Phone:480-702-1420
Practice Address - Fax:480-718-7720
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-10
Last Update Date:2023-01-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXAP142768363LP0808X
IL209.019899363LP0808X
CO1652363LP0808X
AZ231793363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health