Basic Information
| Provider Information | |||||||||
| NPI: | 1912937012 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | AGUIAR | ||||||||
| FirstName: | LUIS | ||||||||
| MiddleName: | ORLANDO | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2150 W 76TH ST | ||||||||
| Address2: | SUITE 110 | ||||||||
| City: | HIALEAH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 330161839 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3058219791 | ||||||||
| FaxNumber: | 3058276783 | ||||||||
| Practice Location | |||||||||
| Address1: | 2150 W 76TH ST | ||||||||
| Address2: | SUITE 110 | ||||||||
| City: | HIALEAH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 330161839 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3058219791 | ||||||||
| FaxNumber: | 3058276783 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/04/2006 | ||||||||
| LastUpdateDate: | 10/20/2011 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | ME42071 | FL | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 96516B | 01 | FL | MEDICARE NUMBER | OTHER |