Provider Demographics
NPI:1538927454
Name:AGUADO, ANDREW MAURICE ENCOMIENDA (RT(R)(CT)(ARRT))
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:MAURICE ENCOMIENDA
Last Name:AGUADO
Suffix:
Gender:M
Credentials:RT(R)(CT)(ARRT)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:94-515 PALAI ST
Mailing Address - Street 2:
Mailing Address - City:WAIPAHU
Mailing Address - State:HI
Mailing Address - Zip Code:96797-1268
Mailing Address - Country:US
Mailing Address - Phone:808-797-1169
Mailing Address - Fax:
Practice Address - Street 1:94-515 PALAI ST
Practice Address - Street 2:
Practice Address - City:WAIPAHU
Practice Address - State:HI
Practice Address - Zip Code:96797-1268
Practice Address - Country:US
Practice Address - Phone:808-797-1169
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-06
Last Update Date:2024-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIR-61562085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology