Organization
OTOPLASTIKOS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. AJANI G NUGENT MD (AUTHROIZED REPRESENTATIVE)
(404) 550-9857
Entity
Organization
Contact information
Practice address
41 SE 5TH ST, APT 916, MIAMI, FL 33131-2529
(404) 550-9857
Mailing address
41 SE 5TH ST, APT 916, MIAMI, FL 33131-2529
(404) 550-9857
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
ME125166
FL
208200000X
Plastic Surgery Physician
ME125166
FL
Other
Enumeration date
01/25/2016
Last updated
01/25/2016
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