Provider Demographics
NPI:1962482315
Name:AQUINO, SHEILA MALACAT (ARNP)
Entity Type:Individual
Prefix:
First Name:SHEILA
Middle Name:MALACAT
Last Name:AQUINO
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14100 FIVAY RD
Mailing Address - Street 2:SUITE 250
Mailing Address - City:HUDSON
Mailing Address - State:FL
Mailing Address - Zip Code:34667-7180
Mailing Address - Country:US
Mailing Address - Phone:727-869-7822
Mailing Address - Fax:727-869-3688
Practice Address - Street 1:14100 FIVAY RD
Practice Address - Street 2:SUITE 250
Practice Address - City:HUDSON
Practice Address - State:FL
Practice Address - Zip Code:34667-7180
Practice Address - Country:US
Practice Address - Phone:727-869-7822
Practice Address - Fax:727-869-3688
Is Sole Proprietor?:No
Enumeration Date:2006-01-20
Last Update Date:2012-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLANT2673042363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLP00163685OtherRAIL ROAD MEDICARE
FLY064KOtherBCBS
FLP00163685OtherRAIL ROAD MEDICARE
FLU3530ZMedicare ID - Type Unspecified