Provider Demographics
NPI:1649227240
Name:AGUIAR, PORFIRIO A (MD)
Entity type:Individual
Prefix:DR
First Name:PORFIRIO
Middle Name:A
Last Name:AGUIAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:5202 N ELK RIVER RD
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89511-5640
Mailing Address - Country:US
Mailing Address - Phone:775-853-7620
Mailing Address - Fax:775-853-7620
Practice Address - Street 1:6880 S MCCARRAN BLVD
Practice Address - Street 2:SUITE A-14
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89509-6104
Practice Address - Country:US
Practice Address - Phone:775-828-5444
Practice Address - Fax:775-828-5458
Is Sole Proprietor?:No
Enumeration Date:2006-05-28
Last Update Date:2008-06-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NV6773207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV002016363Medicaid
NV002016363Medicaid
F62636Medicare UPIN