Provider Demographics
NPI:1871314351
Name:AQUINO, CARLOS RAFAEL
Entity type:Individual
Prefix:
First Name:CARLOS
Middle Name:RAFAEL
Last Name:AQUINO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13176 SW 10TH TERRACE DR
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33184-2060
Mailing Address - Country:US
Mailing Address - Phone:786-552-2485
Mailing Address - Fax:
Practice Address - Street 1:3300 S UNIVERSITY DR FL 33328
Practice Address - Street 2:
Practice Address - City:FT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33328-2004
Practice Address - Country:US
Practice Address - Phone:800-541-6682
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-18
Last Update Date:2024-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program