Provider Demographics
NPI:1548015696
Name:MUZAURIETA, AURELIO ALBERTO (MD)
Entity type:Individual
Prefix:
First Name:AURELIO
Middle Name:ALBERTO
Last Name:MUZAURIETA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2221 SEGOVIA AVE
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32217-2622
Mailing Address - Country:US
Mailing Address - Phone:904-238-5128
Mailing Address - Fax:
Practice Address - Street 1:1199 WELCH RD
Practice Address - Street 2:
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94304-1905
Practice Address - Country:US
Practice Address - Phone:904-238-5128
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-22
Last Update Date:2024-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program