Provider Demographics
NPI:1134854540
Name:AGUILAR, FERNANDO ANTONIO
Entity type:Individual
Prefix:DR
First Name:FERNANDO
Middle Name:ANTONIO
Last Name:AGUILAR
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2903 WELLER RD
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20906-3886
Mailing Address - Country:US
Mailing Address - Phone:301-512-4112
Mailing Address - Fax:
Practice Address - Street 1:2903 WELLER RD
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20906-3886
Practice Address - Country:US
Practice Address - Phone:301-512-4112
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-19
Last Update Date:2023-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDTA2890152W00000X, 152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist