Provider Demographics
NPI:1699858100
Name:AGUIAR, JOSE
Entity Type:Individual
Prefix:
First Name:JOSE
Middle Name:
Last Name:AGUIAR
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:728 CAMILO AVE
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-7008
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:215 SW 17TH AVE
Practice Address - Street 2:201
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33135-3689
Practice Address - Country:US
Practice Address - Phone:305-642-9411
Practice Address - Fax:305-642-3544
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME40709208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice