Provider Demographics
NPI:1760129019
Name:AGUILA, CHRISTOPHER MICHAEL (PA-C)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:MICHAEL
Last Name:AGUILA
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8750 SW 144TH ST STE 100
Mailing Address - Street 2:
Mailing Address - City:PALMETTO BAY
Mailing Address - State:FL
Mailing Address - Zip Code:33176-7229
Mailing Address - Country:US
Mailing Address - Phone:305-323-9658
Mailing Address - Fax:
Practice Address - Street 1:8750 SW 144TH ST STE 100
Practice Address - Street 2:
Practice Address - City:PALMETTO BAY
Practice Address - State:FL
Practice Address - Zip Code:33176-7229
Practice Address - Country:US
Practice Address - Phone:305-323-9658
Practice Address - Fax:786-596-3840
Is Sole Proprietor?:No
Enumeration Date:2022-05-18
Last Update Date:2022-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9115929363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical