Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | ARNP9438043 | FL |
NPI | 1003362716 |
---|---|
Provider Name | Jonathan Aguas |
First Address | Orlando, FL 32806 |
Second Address | Orlando, FL 32806-2002 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/09/2016 |
Last Update Date | 01/09/2016 |