# AGAVE FAMILY MEDICINE

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1407809387
- **Authorized official:** CHARLES A MICHIELI MD (PRESIDENT)
- **Authorized official phone:** (520) 744-2441

## Contact information

- **Practice address:** 8710 N THORNYDALE RD, STE 160, TUCSON, AZ 85742-5031
- **Practice address phone:** (520) 744-2441
- **Mailing address:** PO BOX 43100, TUCSON, AZ 85733-3100
- **Mailing address phone:** (520) 722-3777

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 33407 | AZ | Yes |

## Other

- **Enumeration date:** 05/19/2006
- **Last updated:** 08/22/2020