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General NPI Number Information
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NPI Number | 1326324252
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Entity Type | Organization
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Legal Business Name | FONTAINEBLEAU MEDICAL CENTER CORP
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Dates
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Enumeration Date | 10/24/2011
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Last Update Date | 01/09/2012
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Provider Practice Location Address
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Address Line | 175 FONTAINEBLEAU BLVD SUITE 1P1
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City | MIAMI
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State | FL
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Zip | 33172-7018
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Country | US
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Telephone | 305-227-1377
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Fax | 305-229-1377
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Provider Business Mailing Address
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Address Line | 175 FONTAINEBLEAU BLVD SUITE 1P1
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City | MIAMI
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State | FL
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Zip | 33172-7018
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Country | US
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Telephone | 305-227-1377
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Fax | 305-229-1377
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. CARLOS E AGUILAR
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Credential | M.D
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Telephone | 305-227-1377
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | ME65110
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License Number State | FL
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