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General NPI Number Information
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NPI Number | 1194728964
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Entity Type | Individual
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Provider Name | CELSO AGNER M.D., MSC
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Gender | Male
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Dates
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Enumeration Date | 05/24/2005
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Last Update Date | 04/01/2024
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Provider Practice Location Address
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Address Line | 1625 SE 3RD AVENUE SUITE 623
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City | FORT LAUDERDALE
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State | FL
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Zip | 33316-2521
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Country | US
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Telephone | 954-320-3322
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Fax | 954-462-7410
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Provider Business Mailing Address
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Address Line | 1700 NW 49TH ST STE 125
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City | FORT LAUDERDALE
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State | FL
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Zip | 33309-3763
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 227395
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 036-116408
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 2084V0102X
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Taxonomy Name | Vascular Neurology Physician
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License Number | ME 117153
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License Number State | FL
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