Organization
AXEN SEPA 2 INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL SELLINGER (CFO)
(917) 514-7007
Entity
Organization
Contact information
Practice address
10621 N KENDALL DR STE 211, MIAMI, FL 33176-1530
(305) 596-4288
(786) 703-3571
Mailing address
2103 CORAL WAY, 2ND FLOOR, MIAMI, FL 33145
(917) 514-7007
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
—
—
Other
Enumeration date
05/15/2023
Last updated
05/15/2023
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