MEDICARE: SETH AGUINAGA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	164W00000X	Licensed Practical Nurse	4703113181	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	A252762799881	OTHER	MI	DRIVERS LICENSE

General Provider Information

NPI Number	:	1033610589
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SETH AGUINAGA

Provider Business Mailing Address
First Line	:	1902 STAR BATT DR
Second Line	:
City	:	ROCHESTER HILLS
State	:	MI
Zip	:	48309-3711
Country	:	US
Telephone Number	:	248-844-9650
Fax Number	:

Provider Business Practice Location Address
First Line	:	1902 STAR BATT DR
Second Line	:
City	:	ROCHESTER HILLS
State	:	MI
Zip	:	48309-3711
Country	:	US
Telephone Number	:	248-844-9650
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/21/2018
Last Update Date	:	02/21/2018

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Directions to “ SETH AGUINAGA ” Practice Location

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