Healthcare Provider Details

I. General information

NPI: 1730003591
Provider Name (Legal Business Name): JOEFWEN MILAGROSO AGUILAR
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

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

III. Provider practice location address

801 W JUDGE PEREZ DR STE A
CHALMETTE LA
70043-4883
US

IV. Provider business mailing address

3713 JEAN PL
METAIRIE LA
70002-4509
US

V. Phone/Fax

Practice location:
  • Phone: 504-278-7567
  • Fax:
Mailing address:
  • Phone: 727-608-0474
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: