Provider Demographics
NPI:1588554372
Name:UNDERWOOD AGUILAR, MIKAYLA GRACE (DVM)
Entity type:Individual
Prefix:
First Name:MIKAYLA
Middle Name:GRACE
Last Name:UNDERWOOD AGUILAR
Suffix:
Gender:F
Credentials:DVM
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:407 S 42ND ST APT 1R
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104-4092
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3900 SPRUCE ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104-4113
Practice Address - Country:US
Practice Address - Phone:215-746-8387
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-03
Last Update Date:2025-07-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PA174M00000X208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PABV017631OtherSTATE BOARD OF VETERINARY MEDICINE