Provider Demographics
NPI:1891802724
Name:AGUILAR, JOSEFINO CRUZ (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSEFINO
Middle Name:CRUZ
Last Name:AGUILAR
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 1:15330 HWY 231 431 N
Mailing Address - Street 2:
Mailing Address - City:HAZEL GREEN
Mailing Address - State:AL
Mailing Address - Zip Code:35750
Mailing Address - Country:US
Mailing Address - Phone:256-828-3321
Mailing Address - Fax:256-828-6696
Practice Address - Street 1:15330 HWY 231 431 N
Practice Address - Street 2:
Practice Address - City:HAZEL GREEN
Practice Address - State:AL
Practice Address - Zip Code:35750
Practice Address - Country:US
Practice Address - Phone:256-828-3321
Practice Address - Fax:256-828-6696
Is Sole Proprietor?:No
Enumeration Date:2006-08-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL9646207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
000012016Medicare ID - Type Unspecified