Provider Demographics
NPI:1700199536
Name:JAIME A. AGUINALDO INC
Entity Type:Organization
Organization Name:JAIME A. AGUINALDO INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAIME
Authorized Official - Middle Name:A
Authorized Official - Last Name:AGUINALDO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:314-644-5300
Mailing Address - Street 1:13112 THORNHILL DR
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63131-1717
Mailing Address - Country:US
Mailing Address - Phone:314-644-5300
Mailing Address - Fax:314-644-5308
Practice Address - Street 1:3915 WATSON RD
Practice Address - Street 2:STE. 101
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63109-1251
Practice Address - Country:US
Practice Address - Phone:314-644-5300
Practice Address - Fax:314-644-5308
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-21
Last Update Date:2014-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty