Organization
ASTORIA OF MIDDLE GA LLC
Active
Organization
ASTORIA OF MIDDLE GA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WILLIAM ENRIQUE AGUDELO CRNA (PRESIDENT)
(478) 787-9153
Entity
Organization
Contact information
Practice address
403 LAKEVIEW PL, MACON, GA 31211-6127
(478) 787-9153
Mailing address
403 LAKEVIEW PL, MACON, GA 31211-6127
(478) 787-9153
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
Other
Enumeration date
03/05/2012
Last updated
06/08/2012
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