Provider Demographics
NPI:1932252202
Name:ARAGON & ARAGON MDS PA
Entity Type:Organization
Organization Name:ARAGON & ARAGON MDS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN PRESIDENT OF CORPORATION
Authorized Official - Prefix:DR
Authorized Official - First Name:GLORIA
Authorized Official - Middle Name:R
Authorized Official - Last Name:ARAGON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:863-763-6496
Mailing Address - Street 1:1004 N PARROTT AVE
Mailing Address - Street 2:
Mailing Address - City:OKEECHOBEE
Mailing Address - State:FL
Mailing Address - Zip Code:34972-2110
Mailing Address - Country:US
Mailing Address - Phone:863-763-6496
Mailing Address - Fax:863-763-1965
Practice Address - Street 1:1004 N PARROTT AVE
Practice Address - Street 2:
Practice Address - City:OKEECHOBEE
Practice Address - State:FL
Practice Address - Zip Code:34972-2110
Practice Address - Country:US
Practice Address - Phone:863-763-6496
Practice Address - Fax:863-763-1965
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-19
Last Update Date:2007-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLI10359Medicare UPIN
FL00885Medicare ID - Type UnspecifiedGROUP MEDICARE #
FLD54984Medicare UPIN
FLD54987Medicare UPIN