Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0202X | Pediatric Cardiologist | ME70636 | FL |
NPI | 1003910340 |
---|---|
Provider Name | Maximo Raul Aguirre |
First Address | Pembroke Pines, FL 33026-1900 |
Second Address | Pembroke Pines, FL 33026-1900 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/09/2006 |
Last Update Date | 15/12/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
250153800 | (05) | FL |