Organization
AVS MEDICAL LLC
Active
Other names
MedNova Primary Care
Organization subpart
No
Provider details
NPI number
Authorized official
DR. AGUSTIN VEGA SANTIAGO MD (PHYSICIAN/ OWNER)
(787) 969-0534
Entity
Organization
Contact information
Practice address
4691 OLD CANOE CREEK RD, SAINT CLOUD, FL 34769-1550
(407) 498-4015
Mailing address
8149 GAMEMASTER AVE, ORLANDO, FL 32832-5074
(787) 969-0534
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
09/21/2022
Last updated
09/21/2022
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