MEDICARE: MRS. CAROL AGUIRRE MS RDLDN

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	133V00000X	Registered Dietitian	ND 4824	FL

General Provider Information

NPI Number	:	1942415989
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CAROL AGUIRRE MS RDLDN

Provider Business Mailing Address
First Line	:	715 BAYSHORE DR APT 705
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33304-3991
Country	:	US
Telephone Number	:	954-298-1829
Fax Number	:

Provider Business Practice Location Address
First Line	:	2598 E SUNRISE BLVD STE 210A
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33304-3230
Country	:	US
Telephone Number	:	954-603-4433
Fax Number	:

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

Provider Enumeration Date	:	05/12/2007
Last Update Date	:	03/08/2018

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