Provider Demographics
NPI:1710173794
Name:ALDRICH, JOSE JOAQUIN (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSE
Middle Name:JOAQUIN
Last Name:ALDRICH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:351 NW 42ND AVE
Mailing Address - Street 2:SUITE 404
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126-5688
Mailing Address - Country:US
Mailing Address - Phone:305-856-5733
Mailing Address - Fax:305-441-0396
Practice Address - Street 1:351 NW 42ND AVE
Practice Address - Street 2:SUITE 404
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33126-5688
Practice Address - Country:US
Practice Address - Phone:305-856-5733
Practice Address - Fax:305-441-0396
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-24
Last Update Date:2020-10-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME37778207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL96068Medicare PIN