Healthcare Provider Details

I. General information

NPI: 1346365632
Provider Name (Legal Business Name): CARLOS ARMANDO AGUILAR M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/19/2007
Last Update Date: 09/20/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2123 AUBURN AVE SUITE A28
CINCINNATI OH
45219-2906
US

IV. Provider business mailing address

2123 AUBURN AVE SUITE A28
CINCINNATI OH
45219-2906
US

V. Phone/Fax

Practice location:
  • Phone: 513-585-2472
  • Fax: 513-585-4094
Mailing address:
  • Phone: 513-585-2472
  • Fax: 513-585-4094

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2083C0008X
TaxonomyClinical Informatics Physician
License Number070448
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number35.092571
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: