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NPI Code Detail

MEDICARE: MR. JOSE ANSELMO AGUIRRE PT

MEDICARE:  MR. JOSE ANSELMO AGUIRRE  PT
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
1174400000XSpecialistPT 22575FL

General Provider Information

NPI Number : 1891961777
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. JOSE ANSELMO AGUIRRE PT
Provider Business Mailing Address
First Line : 2718 LEE BLVD
Second Line : STE C
City : LEHIGH ACRES
State : FL
Zip : 33971-1537
Country : US
Telephone Number : 239-303-1501
Fax Number : 239-303-9297
Provider Business Practice Location Address
First Line : 2718 LEE BLVD
Second Line : STE C
City : LEHIGH ACRES
State : FL
Zip : 33971-1537
Country : US
Telephone Number : 239-303-1501
Fax Number : 239-303-9297
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/01/2008
Last Update Date : 05/01/2008

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Directions to “ MR. JOSE ANSELMO AGUIRRE PT” Practice Location

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