Provider Demographics
NPI:1285628008
Name:ARAGON, GLORIA R (MD)
Entity type:Individual
Prefix:MRS
First Name:GLORIA
Middle Name:R
Last Name:ARAGON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1004 N PARROTT AVE
Mailing Address - Street 2:
Mailing Address - City:OKEECHOBEE
Mailing Address - State:FL
Mailing Address - Zip Code:34972-2110
Mailing Address - Country:US
Mailing Address - Phone:863-763-6496
Mailing Address - Fax:863-763-1965
Practice Address - Street 1:1004 N PARROTT AVE
Practice Address - Street 2:
Practice Address - City:OKEECHOBEE
Practice Address - State:FL
Practice Address - Zip Code:34972-2110
Practice Address - Country:US
Practice Address - Phone:863-763-6496
Practice Address - Fax:863-763-1965
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME21207207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL47017OtherBLUE CROSS BLUE SHIELD
D54984Medicare UPIN
470172Medicare ID - Type Unspecified