Provider Demographics
NPI:1255203931
Name:SAULEDA AGUINAGA, LORENA (PA-C)
Entity type:Individual
Prefix:
First Name:LORENA
Middle Name:
Last Name:SAULEDA AGUINAGA
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15676 NW 12TH MNR
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33028-1676
Mailing Address - Country:US
Mailing Address - Phone:954-980-3824
Mailing Address - Fax:
Practice Address - Street 1:7737 N UNIVERSITY DR STE 104B
Practice Address - Street 2:
Practice Address - City:TAMARAC
Practice Address - State:FL
Practice Address - Zip Code:33321-2968
Practice Address - Country:US
Practice Address - Phone:954-980-3824
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-22
Last Update Date:2025-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9120175363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant