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General NPI Number Information
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NPI Number | 1538348909
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Entity Type | Individual
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Provider Name | RICHARD GLENN GARCIA AGUILERA MD
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Gender | Male
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Dates
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Enumeration Date | 11/01/2007
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Last Update Date | 12/29/2011
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Provider Practice Location Address
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Address Line | 9500 EUCLID AVE # S31
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City | CLEVELAND
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State | OH
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Zip | 44195-1900
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Country | US
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Telephone | 216-445-4976
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Fax |
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Provider Business Mailing Address
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Address Line | 21940 BRIARWOOD DR
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City | FAIRVIEW PARK
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State | OH
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Zip | 44126-2659
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Country | US
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Telephone | 440-716-8734
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 57013235
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License Number State | OH
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