Healthcare Provider Details

I. General information

NPI: 1932177367
Provider Name (Legal Business Name): GEORGINA AGUIRRE M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 03/10/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

396 ZONA IND REPARADA 2
PONCE PR
00716-2347
US

IV. Provider business mailing address

20 CALLE RUIZ BELVIS
SANTA ISABEL PR
00757-2670
US

V. Phone/Fax

Practice location:
  • Phone: 787-840-0052
  • Fax: 787-848-1306
Mailing address:
  • Phone: 787-825-6377
  • Fax: 787-848-1306

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number9099
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: