MEDICARE: ESEL AGUILAR CBHCMS/FMD/BS

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	104100000X	Social Worker

General Provider Information

NPI Number	:	1174760458
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ESEL AGUILAR CBHCMS/FMD/BS

Provider Business Mailing Address
First Line	:	382 NE 19TH AVE
Second Line	:
City	:	HOMESTEAD
State	:	FL
Zip	:	33033-5265
Country	:	US
Telephone Number	:	786-975-7485
Fax Number	:

Provider Business Practice Location Address
First Line	:	12001 SW 128TH CT STE 101
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33186-4665
Country	:	US
Telephone Number	:	954-860-7166
Fax Number	:

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

Provider Enumeration Date	:	01/08/2009
Last Update Date	:	03/16/2022

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