Provider Demographics
NPI:1891786141
Name:AGUIAR-OLSEN, RINELY (MD)
Entity type:Individual
Prefix:
First Name:RINELY
Middle Name:
Last Name:AGUIAR-OLSEN
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 1:2285 S ELKS LN
Mailing Address - Street 2:
Mailing Address - City:YUMA
Mailing Address - State:AZ
Mailing Address - Zip Code:85364-6258
Mailing Address - Country:US
Mailing Address - Phone:928-329-4761
Mailing Address - Fax:928-329-4448
Practice Address - Street 1:2285 S ELKS LN
Practice Address - Street 2:
Practice Address - City:YUMA
Practice Address - State:AZ
Practice Address - Zip Code:85364-6258
Practice Address - Country:US
Practice Address - Phone:928-329-4761
Practice Address - Fax:928-329-4448
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-03
Last Update Date:2008-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ28377207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ51607302Medicaid
AZ1891786141OtherHEALTHNET
AZ1891786141OtherBLUE CROSS AND BLUE SHIELD
AZ119163Medicare PIN
AZH18165Medicare UPIN