Healthcare Provider Details

I. General information

NPI: 1013577998
Provider Name (Legal Business Name): AARON RENE ALLICK DOUEN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: AARON DOUEN M.D.

II. Dates (important events)

Enumeration Date: 06/13/2019
Last Update Date: 04/25/2024
Certification Date: 04/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16400 S HIGHWAY 25
WEIRSDALE FL
32195-2442
US

IV. Provider business mailing address

425 NURSING HOME DR
ARCADIA FL
34266-3839
US

V. Phone/Fax

Practice location:
  • Phone: 352-821-9797
  • Fax: 352-821-0553
Mailing address:
  • Phone: 639-932-9668
  • Fax: 863-494-5491

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME161913
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: