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General NPI Number Information
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NPI Number | 1023300746
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Entity Type | Organization
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Legal Business Name | OGTON HEALTH GROUP, INC.
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Dates
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Enumeration Date | 05/13/2011
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Last Update Date | 05/13/2011
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Provider Practice Location Address
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Address Line | 1613 N HIATUS RD
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City | PEMBROKE PINES
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State | FL
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Zip | 33026-2129
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Country | US
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Telephone | 954-558-5248
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Fax |
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Provider Business Mailing Address
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Address Line | 1613 N HIATUS RD
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City | PEMBROKE PINES
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State | FL
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Zip | 33026-2129
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Country | US
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Telephone | 954-558-5248
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. SELWYN A CARRINGTON JR.
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Credential | MBA
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Telephone | 954-558-5248
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number |
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License Number State | FL
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