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NPI Code Detail

MEDICARE: SUSY AGUIAR

MEDICARE: SUSY AGUIAR
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
1390200000XStudent in an Organized Health Care Education/Training Program
2367500000XCertified Registered Nurse AnesthetistRN234804GA

General Provider Information

NPI Number : 1639752488
Entity Type Code : Individual
Provider Name (Legal Business Name) : SUSY AGUIAR
Provider Business Mailing Address
First Line : 5040 WAGON TRL
Second Line :
City : CUMMING
State : GA
Zip : 30028-3427
Country : US
Telephone Number : 954-558-8666
Fax Number :
Provider Business Practice Location Address
First Line : 6335 HOSPITAL PKWY STE 304
Second Line :
City : DULUTH
State : GA
Zip : 30097-5712
Country : US
Telephone Number : 404-778-8311
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/29/2021
Last Update Date : 10/23/2021

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Directions to “ SUSY AGUIAR ” Practice Location

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