Healthcare Provider Details

I. General information

NPI: 1518895812
Provider Name (Legal Business Name): GERARD F. ACLOQUE MD LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/08/2026
Last Update Date: 07/17/2026
Certification Date: 07/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5555 HOLLYWOOD BLVD STE 201
HOLLYWOOD FL
33021-6420
US

IV. Provider business mailing address

5555 HOLLYWOOD BLVD STE 201
HOLLYWOOD FL
33021-6420
US

V. Phone/Fax

Practice location:
  • Phone: 954-932-3269
  • Fax: 954-405-8477
Mailing address:
  • Phone: 954-932-3269
  • Fax: 954-405-8477

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. GERARD F ACLOQUE JR.
Title or Position: OWNER
Credential: MD
Phone: 954-932-3269