Aqua, Keith Andrew

Aqua, Keith Andrew is an individual health care provider with primary practice located at 1395 S State Road 7 Suite 450, Wellington FL 33414-9325. He recently has only one registered license in Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, which is considered as his primary health care specialty. Aqua, Keith Andrew can be contacted via phone (561) 798-1233.

Contact Information

Primary practice address
1395 S State Road 7 Suite 450 Wellington FL 33414-9325
Phone: (561) 798-1233
Fax: (561) 798-1655
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X ME68312 Florida

Profile Details

NPI number 1336105600
LBN Legal business name Aqua, Keith Andrew
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 25th, 2006
Last updated Feb 4th, 2022 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1336105600 NPPES
Florida MEDICAID 250485500

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