Provider Demographics
NPI:1295976454
Name:AGUINA QUIODETTIS, LUZ MARIEL (MD)
Entity type:Individual
Prefix:
First Name:LUZ
Middle Name:MARIEL
Last Name:AGUINA QUIODETTIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:LUZ
Other - Middle Name:MARIEL
Other - Last Name:AGUINA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:901 BRICKELL KEY BLVD APT 3406
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33131-3515
Mailing Address - Country:US
Mailing Address - Phone:630-666-9155
Mailing Address - Fax:
Practice Address - Street 1:3663 S MIAMI AVE STE 2356
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33133-4253
Practice Address - Country:US
Practice Address - Phone:305-285-2771
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-03-18
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME131880207L00000X
KY390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology