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NPI Code Detail

MEDICARE: EDGARDO LAGUILLO MD

MEDICARE:   EDGARDO  LAGUILLO  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
1207Q00000XFamily Medicine Physician24045AZ

Other Identifiers

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

General Provider Information

NPI Number : 1629051560
Entity Type Code : Individual
Provider Name (Legal Business Name) : EDGARDO LAGUILLO MD
Provider Business Mailing Address
First Line : PO BOX 31235
Second Line :
City : TUCSON
State : AZ
Zip : 85751-1235
Country : US
Telephone Number : 520-324-4100
Fax Number : 520-324-1406
Provider Business Practice Location Address
First Line : 9348 E RITA RD
Second Line : SUITE 100
City : TUCSON
State : AZ
Zip : 85747
Country : US
Telephone Number : 520-324-4760
Fax Number : 520-324-4759
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/23/2005
Last Update Date : 03/21/2023

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Directions to “ EDGARDO LAGUILLO MD” Practice Location

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