Healthcare Provider Details

I. General information

NPI: 1295579464
Provider Name (Legal Business Name): ISEL DE LOS ANGELES AGUILAR FIGUEREDO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/22/2024
Last Update Date: 07/01/2024
Certification Date: 07/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

G3375 S SAGINAW ST
FLINT MI
48529-1277
US

IV. Provider business mailing address

12468 SW 121ST AVE
MIAMI FL
33186-5169
US

V. Phone/Fax

Practice location:
  • Phone: 810-406-4246
  • Fax:
Mailing address:
  • Phone: 214-417-2061
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: