MEDICARE: ANDREA TERESA AGUIRRE

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	208100000X	Physical Medicine & Rehabilitation Physician	ME151333	FL
2	2081P0004X	Spinal Cord Injury Medicine Physician	ME151333	FL
3	208100000X	Physical Medicine & Rehabilitation Physician	11730980-1205	UT

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	:	1760844914
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDREA TERESA AGUIRRE

Provider Business Mailing Address
First Line	:	PO BOX 27128
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84127-0128
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5171 S COTTONWOOD ST STE 910
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84107-5759
Country	:	US
Telephone Number	:	801-507-9950
Fax Number	:

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

Provider Enumeration Date	:	03/27/2016
Last Update Date	:	02/06/2026

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