Healthcare Provider Details

I. General information

NPI: 1982136560
Provider Name (Legal Business Name): DIANA MERCEDES MOSQUERA AGUIRRE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/01/2017
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1002 S OLD DIXIE HWY STE 201
JUPITER FL
33458-7202
US

IV. Provider business mailing address

1002 S OLD DIXIE HWY STE 201
JUPITER FL
33458-7202
US

V. Phone/Fax

Practice location:
  • Phone: 561-744-2200
  • Fax: 561-744-3083
Mailing address:
  • Phone: 561-744-2200
  • Fax: 561-744-3083

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberME183726
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberU4877
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: