Individual
LUANN AQUINO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
021580
SC
207R00000X
Internal Medicine Physician
045035
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000845633C
—
GA
01
—
10063403
AMERIGROUP
GA
05
—
215805
—
SC
01
—
349710
WELLCARE
GA
01
—
P00121486
RR MEDICARE
GA
Enumeration date
07/18/2006
Last updated
10/29/2014
Update your record
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