Provider Demographics
NPI:1770848897
Name:AGUILERA, NAOMI (OD)
Entity Type:Individual
Prefix:DR
First Name:NAOMI
Middle Name:
Last Name:AGUILERA
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 S PATRICK DR STE 7
Mailing Address - Street 2:
Mailing Address - City:INDIAN HARBOUR BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32937-4462
Mailing Address - Country:US
Mailing Address - Phone:321-777-2000
Mailing Address - Fax:
Practice Address - Street 1:2000 S PATRICK DR STE 7
Practice Address - Street 2:
Practice Address - City:INDIAN HARBOUR BEACH
Practice Address - State:FL
Practice Address - Zip Code:32937-4462
Practice Address - Country:US
Practice Address - Phone:321-777-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-05
Last Update Date:2024-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX7989T152WC0802X, 152W00000X, 152WL0500X, 152WP0200X, 152WS0006X, 152WV0400X
FLOPC4862152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
No152WL0500XEye and Vision Services ProvidersOptometristLow Vision Rehabilitation
No152WP0200XEye and Vision Services ProvidersOptometristPediatrics
No152WS0006XEye and Vision Services ProvidersOptometristSports Vision
No152WV0400XEye and Vision Services ProvidersOptometristVision Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLHS989ZMedicare PIN