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Organization

AD ASTRA MEDICAL GROUP PROFESSIONAL

Active
Organization subpart
No

Provider details

NPI number
Authorized official
NHEAN DAWANCE CHEA MD (CEO, MEDICAL DIRECTOR)
(917) 853-7642
Entity
Organization

Contact information

Practice address
3110 GRAND AVE, PINELLAS PARK, FL 33782-6151
(917) 853-7642
Mailing address
3110 GRAND AVE APT 3212, PINELLAS PARK, FL 33782-6170
(917) 853-7642

Taxonomy

Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary

Other

Enumeration date
01/12/2022
Last updated
01/21/2022
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