Provider Demographics
NPI:1184432668
Name:AGUILAR, IGNACIO III (DNP, CRNA)
Entity type:Individual
Prefix:DR
First Name:IGNACIO
Middle Name:
Last Name:AGUILAR
Suffix:III
Gender:M
Credentials:DNP, CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18102 S AVENUE B 1/2
Mailing Address - Street 2:
Mailing Address - City:SOMERTON
Mailing Address - State:AZ
Mailing Address - Zip Code:85350-8100
Mailing Address - Country:US
Mailing Address - Phone:909-206-7729
Mailing Address - Fax:
Practice Address - Street 1:18102 S AVENUE B 1/2
Practice Address - Street 2:
Practice Address - City:SOMERTON
Practice Address - State:AZ
Practice Address - Zip Code:85350-8100
Practice Address - Country:US
Practice Address - Phone:909-206-7729
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-30
Last Update Date:2024-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ232231163W00000X
CA95237338163W00000X
OHAPRN.CRNA.0021179367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse