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NPI Code Detail

MEDICARE: AGOO HEALTH, LLC

MEDICARE: AGOO HEALTH, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207KA0200XAllergy Physician
2251E00000XHome Health Agency
3251K00000XPublic Health or Welfare Agency
4374U00000XHome Health Aide
5251G00000XCommunity Based Hospice Care Agency

General Provider Information

NPI Number : 1073109732
Entity Type Code : Organization
Provider Name (Legal Business Name) : AGOO HEALTH, LLC
Provider Business Mailing Address
First Line : 2221 NE 164TH ST STE 296
Second Line :
City : AVENTURA
State : FL
Zip : 33160-3703
Country : US
Telephone Number : 888-929-2327
Fax Number :
Provider Business Practice Location Address
First Line : 3601 W COMMERCIAL BLVD STE 14
Second Line :
City : FORT LAUDERDALE
State : FL
Zip : 33309-3320
Country : US
Telephone Number : 888-929-2327
Fax Number :
Authorized Official
Title or Position : CEO
Name : MR. WALLACE MAYER DE ROTHSMAN
Credential :
Telephone Number : 888-929-2327
Provider Enumeration Date : 12/17/2020
Last Update Date : 12/17/2020

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Directions to “AGOO HEALTH, LLC ” Practice Location

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