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NPI Code Detail

MEDICARE: SHINO BAY AGUILERA DO

MEDICARE: SHINO BAY AGUILERA DO
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
1207N00000XDermatology PhysicianOS8398FL

General Provider Information

NPI Number : 1316992514
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHINO BAY AGUILERA DO
Provider Business Mailing Address
First Line : 350 LAS OLAS BLVD
Second Line : SUITE 110
City : FT. LAUDERDALE
State : FL
Zip : 33301
Country : US
Telephone Number : 954-765-3005
Fax Number : 954-765-3007
Provider Business Practice Location Address
First Line : 350 E LAS OLAS BLVD STE 110
Second Line :
City : FT LAUDERDALE
State : FL
Zip : 33301-4214
Country : US
Telephone Number : 954-765-3005
Fax Number : 954-765-3007
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/24/2006
Last Update Date : 07/21/2022

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Directions to “ SHINO BAY AGUILERA DO” Practice Location

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