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General NPI Number Information
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NPI Number | 1720874357
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Entity Type | Organization
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Legal Business Name | AXESO HEALTH LLC
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Dates
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Enumeration Date | 04/18/2025
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Last Update Date | 04/18/2025
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Provider Practice Location Address
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Address Line | 7400 SW 50TH TER STE 300
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City | MIAMI
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State | FL
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Zip | 33155-4487
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Country | US
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Telephone | 954-699-7766
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Fax |
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Provider Business Mailing Address
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Address Line | 3530 W GLENCOE ST
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City | COCONUT GROVE
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State | FL
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Zip | 33133-4023
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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 | CFO
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Name | MR. ANGEL A MONGEOTTI
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Credential |
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Telephone | 954-699-7766
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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