MEDICARE: AMAURY ARAGON P.A.-C.

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	363A00000X	Physician Assistant	PA9101047	FL
2	363AS0400X	Surgical Physician Assistant	PA9101047	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	Y00VV	OTHER	FL	BC BS OF FLORIDA
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1093728602
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMAURY ARAGON P.A.-C.

Provider Business Mailing Address
First Line	:	PO BOX 5134
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33014-1134
Country	:	US
Telephone Number	:	305-463-6690
Fax Number	:	305-463-6693

Provider Business Practice Location Address
First Line	:	7142 LAUREL LN
Second Line	:
City	:	MIAMI LAKES
State	:	FL
Zip	:	33014-2664
Country	:	US
Telephone Number	:	305-463-6690
Fax Number	:	305-463-6693

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

Provider Enumeration Date	:	08/14/2006
Last Update Date	:	06/21/2013

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