Astoria of Middle Ga LLC

NPI #1609140870 in Macon, Georgia

Provider Information

NPI Number: 1609140870
Entity Type: Organization
Organization Name: Astoria of Middle Ga LLC
Primary Specialty: Anesthesiology
Enumeration Date: Mar 5, 2012
Last Updated: Jun 8, 2012

Practice Location

Address: 403 LAKEVIEW PL
City: Macon
State: Georgia
ZIP Code: 31211-6127
Phone: (478) 787-9153

Authorized Official

Name: MR. WILLIAM ENRIQUE AGUDELO, CRNA
Title: PRESIDENT
Phone: (478) 787-9153

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Anesthesiology	207L00000X	Primary

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