Provider Demographics
NPI:1255350005
Name:AGUILAR, JUAN PEDRO (MD)
Entity type:Individual
Prefix:DR
First Name:JUAN
Middle Name:PEDRO
Last Name:AGUILAR
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:747 PONCE DE LEON BLVD
Mailing Address - Street 2:SUITE 402
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-2073
Mailing Address - Country:US
Mailing Address - Phone:305-774-5700
Mailing Address - Fax:305-774-5900
Practice Address - Street 1:747 PONCE DE LEON BLVD
Practice Address - Street 2:SUITE 402
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-2073
Practice Address - Country:US
Practice Address - Phone:305-774-5700
Practice Address - Fax:305-774-5900
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-19
Last Update Date:2019-05-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FL47476174400000X
FLME47476207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
D64028Medicare UPIN
FL96907Medicare PIN