Provider Demographics
NPI:1912362039
Name:AGUILERA, XAVIER (DC)
Entity Type:Individual
Prefix:DR
First Name:XAVIER
Middle Name:
Last Name:AGUILERA
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7780 WICKLOW CIR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32817-1581
Mailing Address - Country:US
Mailing Address - Phone:321-946-3439
Mailing Address - Fax:
Practice Address - Street 1:820 W LAKE MARY BLVD
Practice Address - Street 2:#107
Practice Address - City:SANFORD
Practice Address - State:FL
Practice Address - Zip Code:32773-5946
Practice Address - Country:US
Practice Address - Phone:407-942-3258
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-12-16
Last Update Date:2015-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH11724111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor