MEDICARE: IRLA JASMINE AGUILAR

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	235Z00000X	Speech-Language Pathologist	TSLP16887	AZ

General Provider Information

NPI Number	:	1427806827
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	IRLA JASMINE AGUILAR

Provider Business Mailing Address
First Line	:	2014 N 39TH AVE
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85009-2146
Country	:	US
Telephone Number	:	928-817-2474
Fax Number	:

Provider Business Practice Location Address
First Line	:	5001 W DOBBINS RD
Second Line	:
City	:	LAVEEN
State	:	AZ
Zip	:	85339-9733
Country	:	US
Telephone Number	:	602-237-9100
Fax Number	:

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

Provider Enumeration Date	:	05/09/2024
Last Update Date	:	04/06/2026

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Directions to “ IRLA JASMINE AGUILAR ” Practice Location

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