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1144217860

NPI Code Detail

MEDICARE: FELICITAS G AGANA MD

MEDICARE: FELICITAS G AGANA MD

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
1	208000000X	Pediatrics Physician	ME0068955	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	27529	OTHER	FL	BCBS
2	ME0068955	OTHER	FL	VOLUSIA HEALTH NETWORK
3	ME0068955	OTHER	FL	DCWO
4	ME0068955	OTHER	FL	CMS
5	ME0068955	OTHER	FL	UNITED BENEFITS
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1144217860
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FELICITAS G AGANA MD

Provider Business Mailing Address
First Line	:	PO BOX 9671
Second Line	:
City	:	DAYTONA BEACH
State	:	FL
Zip	:	32120-9671
Country	:	US
Telephone Number	:	386-676-7130
Fax Number	:	386-676-7125

Provider Business Practice Location Address
First Line	:	1340 RIDGEWOOD AVE
Second Line	:
City	:	HOLLY HILL
State	:	FL
Zip	:	32117-2320
Country	:	US
Telephone Number	:	386-676-7100
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/29/2005
Last Update Date	:	02/23/2011

Similar Medicare Providers

1932102159 — JOHNSIE CAROL GRIGG M.D.
Practice Location Address:

1340 RIDGEWOOD AVE
HOLLY HILL, FL
32117-2320

Practice Phone: 386-676-7130
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1629045307 — MS. DIANE C HATCH PA-C
Practice Location Address:

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Practice Fax:

1730107509 — DR. RICHARD LEE BRAITHWAITE M.D.
Practice Location Address:

1340 RIDGEWOOD AVE
HOLLY HILL, FL
32117-2320

Practice Phone: 386-676-7130
Practice Fax: 386-676-7125

1922114909 — DR. JOYCE WRIGHT PHARM.D
Practice Location Address:

1340 RIDGEWOOD AVE
HOLLY HILL, FL
32117-2320

Practice Phone: 386-676-7120
Practice Fax: 386-676-7128

1750498192 — DR. JOSEPH ZUCKERMAN MD
Practice Location Address:

1340 RIDGEWOOD AVE
HOLLY HILL, FL
32117-2320

Practice Phone: 386-615-4087
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1477659845 — MRS. PHYLLIS W HOLLANDSWORTH LMFT
Practice Location Address:

1340 RIDGEWOOD AVE
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32117-2320

Practice Phone: 386-676-7100
Practice Fax: 386-676-7125

Directions to “ FELICITAS G AGANA MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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