Provider Demographics
NPI:1205492956
Name:AGUIRRE, ANGEL LUIS JR (BSN)
Entity type:Individual
Prefix:MR
First Name:ANGEL
Middle Name:LUIS
Last Name:AGUIRRE
Suffix:JR
Gender:M
Credentials:BSN
Other - Prefix:MR
Other - First Name:ANGEL
Other - Middle Name:LUIS
Other - Last Name:AGUIRRE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BSN
Mailing Address - Street 1:PO BOX 947
Mailing Address - Street 2:
Mailing Address - City:SANTA ISABEL
Mailing Address - State:PR
Mailing Address - Zip Code:00757-0947
Mailing Address - Country:US
Mailing Address - Phone:787-908-4072
Mailing Address - Fax:
Practice Address - Street 1:520 CALLE 8 BO PLAYITA CORTADA SECTOR ISLOTE
Practice Address - Street 2:
Practice Address - City:SANTA ISABEL
Practice Address - State:PR
Practice Address - Zip Code:00757-0075
Practice Address - Country:US
Practice Address - Phone:787-908-4072
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-17
Last Update Date:2019-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR84542163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse