Individual provider Active NPI

Rodolfo E. Aguilera, O.D.

  • Optometrist
  • Orlando, FL
National Provider Identifier
1114061165
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2005 Issued in FL
Practice address
8101 S John Young Pkwy
Orlando, FL 32819-9021
Phone
(407) 226-0549
Fax
(407) 354-2465
NPI assigned
Feb 15, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2005 FL Primary

Addresses

Primary practice location

8101 S John Young Pkwy
Orlando, FL 32819-9021

Mailing address

2374 Cilantro Dr
Orlando, FL 32837-6798
Phone (407) 240-1175

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2005FLMDOptometrist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1171497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1114061165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2374 CILANTRO DR",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328376798",
            "telephone_number": "407-240-1175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8101 S JOHN YOUNG PKWY",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328199021",
            "telephone_number": "407-226-0549",
            "fax_number": "407-354-2465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AGUILERA",
        "first_name": "RODOLFO",
        "middle_name": "E.",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "2005",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.