Organization
AHP OF CENTRAL FLORIDA ASC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GREG WACKOWIAK (PRESIDENT)
(770) 945-5330
Entity
Organization
Contact information
Practice address
3079 PEACHTREE INDUSTRIAL BLVD, DULUTH, GA 30097-2215
(770) 945-5330
Mailing address
3079 PEACHTREE INDUSTRIAL BLVD, DULUTH, GA 30097-2215
(770) 945-5330
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
367500000X
Certified Registered Nurse Anesthetist
—
—
Other
Enumeration date
02/04/2009
Last updated
08/28/2009
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