Provider Demographics
NPI:1750169884
Name:AGUIAR, MARCOS
Entity type:Individual
Prefix:
First Name:MARCOS
Middle Name:
Last Name:AGUIAR
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8321 NW 7TH ST APT 305
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126-3916
Mailing Address - Country:US
Mailing Address - Phone:305-303-5342
Mailing Address - Fax:
Practice Address - Street 1:24400 SW 124TH AVE
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33032-4202
Practice Address - Country:US
Practice Address - Phone:305-489-1897
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-19
Last Update Date:2023-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty