Agana, Felicitas G
Agana, Felicitas G is an individual health care provider with primary practice located at 1340 Ridgewood Ave , Holly Hill FL 32117-2320. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Agana, Felicitas G can be contacted via phone (386) 676-7100.Contact Information
Primary practice address
1340 Ridgewood Ave
Holly Hill FL 32117-2320
Phone: (386) 676-7100
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | ME0068955 | Florida |
Profile Details
| NPI number | 1144217860 |
|---|---|
| LBN Legal business name | Agana, Felicitas G |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 29th, 2005 |
| Last updated | Feb 23rd, 2011 - about 15 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1144217860 | NPPES |
| Florida | Other | 27529 | BCBS |
| Florida | Other | ME0068955 | BCBS |
| Florida | Other | ME0068955 | BCBS |
| Florida | Other | ME0068955 | BCBS |
| Florida | Other | ME0068955 | BCBS |
| Florida | MEDICAID | 378482700 | BCBS |
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