MEDICARE: DR. JUAN PEDRO AGUILAR M.D.

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	174400000X	Specialist	47476	FL
2	207W00000X	Ophthalmology Physician	ME47476	FL

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	:	1255350005
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JUAN PEDRO AGUILAR M.D.

Provider Business Mailing Address
First Line	:	747 PONCE DE LEON BLVD
Second Line	:	SUITE 402
City	:	CORAL GABLES
State	:	FL
Zip	:	33134-2073
Country	:	US
Telephone Number	:	305-774-5700
Fax Number	:	305-774-5900

Provider Business Practice Location Address
First Line	:	747 PONCE DE LEON BLVD
Second Line	:	SUITE 402
City	:	CORAL GABLES
State	:	FL
Zip	:	33134-2073
Country	:	US
Telephone Number	:	305-774-5700
Fax Number	:	305-774-5900

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

Provider Enumeration Date	:	07/19/2006
Last Update Date	:	05/08/2019

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