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General NPI Number Information
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NPI Number | 1932531829
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Entity Type | Individual
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Provider Name | GUILLERMO AQUINO R.T.(T)
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Gender | Male
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Dates
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Enumeration Date | 08/02/2013
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Last Update Date | 08/02/2013
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Provider Practice Location Address
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Address Line | 8115 E GALE RD
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City | PRESCOTT VALLEY
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State | AZ
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Zip | 86314-9406
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Country | US
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Telephone | 928-772-0524
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Fax |
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Provider Business Mailing Address
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Address Line | 8115 E GALE RD
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City | PRESCOTT VALLEY
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State | AZ
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Zip | 86314-9406
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Country | US
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Telephone | 928-772-0524
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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 | 2471R0002X
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Taxonomy Name | Radiation Therapy Radiologic Technologist
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License Number | CTT-1099
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 2471R0002X
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Taxonomy Name | Radiation Therapy Radiologic Technologist
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License Number | RHT00101374
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 2471R0002X
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Taxonomy Name | Radiation Therapy Radiologic Technologist
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License Number | 8867519
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License Number State | OH
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Taxonomy #4
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Taxonomy Code | 2471R0002X
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Taxonomy Name | Radiation Therapy Radiologic Technologist
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License Number | 206215
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License Number State | OR
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Taxonomy #5
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Taxonomy Code | 2471R0002X
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Taxonomy Name | Radiation Therapy Radiologic Technologist
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License Number | RT 00008408
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License Number State | WA
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