Provider Demographics
NPI:1457349003
Name:AIHARA, RIE (MD)
Entity Type:Individual
Prefix:
First Name:RIE
Middle Name:
Last Name:AIHARA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2234 COLONIAL BLVD
Mailing Address - Street 2:ATTN: MANAGED CARE DEPT.
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33907-1412
Mailing Address - Country:US
Mailing Address - Phone:239-931-7342
Mailing Address - Fax:239-931-7385
Practice Address - Street 1:8931 COLONIAL CENTER DR
Practice Address - Street 2:SUITE 301
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33905-7809
Practice Address - Country:US
Practice Address - Phone:239-277-5770
Practice Address - Fax:239-985-1911
Is Sole Proprietor?:No
Enumeration Date:2005-10-07
Last Update Date:2016-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0087289208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL268050500Medicaid
FL71445OtherBCBS FL
FLP106362OtherFREEDOM HEALTH
FLP00820729OtherRAILROAD MEDICARE
FLP203192OtherFREEDOM HEALTH - OPTIMUM PROVIDER
FL223551OtherWELLCARE
FL7527458OtherCIGNA
FL223551OtherWELLCARE
FLP106362OtherFREEDOM HEALTH
FL71445YMedicare PIN