Individual provider · NPI-1

Gerardo De La Luz Aguilera, APRN

Nurse Practitioner, Family · Davie, FL

NPI number1447628508

StatusActive

Last updated in NPPESSep 2, 2024

Details

NPI: 1447628508
Entity type: Individual (NPI-1)
Name: Gerardo De La Luz Aguilera
Credential: APRN
Sex: Male
Sole proprietor: Yes
Enumeration date: Sep 7, 2015
Certification date: Sep 2, 2024
Last updated: Sep 2, 2024

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
363LF0000X	Nurse Practitioner, Family	11034711	FL	Yes
246ZC0007X	Specialist/Technologist, Other, Surgical Assistant	13-404	CO

Practice location

8716 Berkley Dr
Davie, FL 33324-4545

Phone 954-702-3977

Mailing address

8716 Berkley Dr
Davie, FL 33324-4545

Phone 954-702-3977

Is something wrong?

This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.