1972907228 NPI number — JORGE A. AGUINAGA, MD

Table of content: (NPI 1972907228)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1972907228 NPI number — JORGE A. AGUINAGA, MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
JORGE A. AGUINAGA, MD
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1972907228
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/15/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
471 US HIGHWAY 1
Provider Second Line Business Mailing Address:
SUITE 104
Provider Business Mailing Address City Name:
KEY WEST
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33040-5625
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
305-923-9030
Provider Business Mailing Address Fax Number:
305-745-9875

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
471 US HIGHWAY 1
Provider Second Line Business Practice Location Address:
SUITE 104
Provider Business Practice Location Address City Name:
KEY WEST
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33040-5625
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
305-923-9030
Provider Business Practice Location Address Fax Number:
305-745-9875
Provider Enumeration Date:
10/15/2014

Additional Information

Authorized Official

Authorized Official Last Name:
AGUINAGA
Authorized Official First Name:
JORGE
Authorized Official Middle Name:
ANTONIO
Authorized Official Title or Position:
SOLE PROPRIETOR
Authorized Official Telephone Number:
305-923-9030

Provider Taxonomy Codes

  • Taxonomy code: 2084P0800X , with the licence number:  ME0077050 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 2715902-00 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com