Provider Demographics
NPI:1861678971
Name:AGUADO, MARIO (MD)
Entity Type:Individual
Prefix:
First Name:MARIO
Middle Name:
Last Name:AGUADO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1800 SW 27TH AVE
Mailing Address - Street 2:SUITE 602
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33145-2457
Mailing Address - Country:US
Mailing Address - Phone:305-529-6517
Mailing Address - Fax:305-529-6518
Practice Address - Street 1:1800 SW 27TH AVE
Practice Address - Street 2:SUITE 602
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33145-2457
Practice Address - Country:US
Practice Address - Phone:305-529-6517
Practice Address - Fax:305-529-6518
Is Sole Proprietor?:No
Enumeration Date:2008-01-18
Last Update Date:2016-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME474752084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLD20873Medicare UPIN