Provider Demographics
NPI:1730123688
Name:AGUILAR, ENRIQUE JOSE
Entity Type:Individual
Prefix:DR
First Name:ENRIQUE
Middle Name:JOSE
Last Name:AGUILAR
Suffix:
Gender:M
Credentials:
Other - Prefix:DR
Other - First Name:ENRIQUE
Other - Middle Name:J
Other - Last Name:AGUILAR
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:1201 NW 16TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33125-1624
Mailing Address - Country:US
Mailing Address - Phone:305-575-3204
Mailing Address - Fax:305-575-3369
Practice Address - Street 1:1201 NW 16TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33125-1624
Practice Address - Country:US
Practice Address - Phone:305-575-3204
Practice Address - Fax:305-575-3369
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME51389207QG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine