Provider Demographics
NPI:1073109732
Name:AGOO HEALTH, LLC
Entity Type:Organization
Organization Name:AGOO HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:WALLACE MAYER
Authorized Official - Middle Name:
Authorized Official - Last Name:DE ROTHSMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:888-929-2327
Mailing Address - Street 1:2221 NE 164TH ST STE 296
Mailing Address - Street 2:
Mailing Address - City:AVENTURA
Mailing Address - State:FL
Mailing Address - Zip Code:33160-3703
Mailing Address - Country:US
Mailing Address - Phone:888-929-2327
Mailing Address - Fax:
Practice Address - Street 1:3601 W COMMERCIAL BLVD STE 14
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33309-3320
Practice Address - Country:US
Practice Address - Phone:888-929-2327
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-17
Last Update Date:2020-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251G00000XAgenciesHospice Care, Community Based
No207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergyGroup - Multi-Specialty
No251E00000XAgenciesHome Health
No251K00000XAgenciesPublic Health or WelfareGroup - Multi-Specialty
No374U00000XNursing Service Related ProvidersHome Health AideGroup - Multi-Specialty