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General NPI Number Information
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NPI Number | 1205677598
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Entity Type | Organization
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Legal Business Name | AQUANOVA TELEHELATH INTELLIGENCE
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Dates
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Enumeration Date | 06/03/2024
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Last Update Date | 06/03/2024
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Provider Practice Location Address
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Address Line | 18004 NW 6TH ST STE 104
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City | PEMBROKE PINES
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State | FL
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Zip | 33029-2823
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Country | US
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Telephone | 800-536-4270
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Fax |
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Provider Business Mailing Address
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Address Line | 18004 NW 6TH ST STE 104
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City | PEMBROKE PINES
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State | FL
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Zip | 33029-2823
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Country | US
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Telephone | 800-536-4270
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Fax |
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | MAX FRANCOIS BENJAMIN
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Credential | MD
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Telephone | 800-209-6550
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number |
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License Number State |
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