MEDICARE: RAFAEL AGUILA MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	025318	GA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1144328717
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RAFAEL AGUILA MD

Provider Business Mailing Address
First Line	:	4300 N POINT PKWY STE 300
Second Line	:
City	:	ALPHARETTA
State	:	GA
Zip	:	30022-4102
Country	:	US
Telephone Number	:	770-442-1911
Fax Number	:

Provider Business Practice Location Address
First Line	:	1531 WATSON BLVD
Second Line	:
City	:	WARNER ROBINS
State	:	GA
Zip	:	31093-3449
Country	:	US
Telephone Number	:	478-918-0770
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/20/2006
Last Update Date	:	05/09/2024

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