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General NPI Number Information
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NPI Number | 1306416326
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Entity Type | Organization
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Legal Business Name | A & G MEDICAL CENTER INC
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Dates
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Enumeration Date | 06/30/2021
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Last Update Date | 05/09/2023
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Provider Practice Location Address
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Address Line | 9600 NW 25TH ST STE 5C
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City | DORAL
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State | FL
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Zip | 33172-1416
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Country | US
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Telephone | 786-439-5279
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Fax |
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Provider Business Mailing Address
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Address Line | 9600 NW 25TH ST STE 5C
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City | DORAL
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State | FL
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Zip | 33172-1416
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Country | US
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Telephone | 786-439-5279
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Fax |
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Authorized Official
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Title or Position | OFFICER
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Name | ALEXANDER LAMS
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Credential |
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Telephone | 786-439-5279
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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