Provider Demographics
NPI:1346883048
Name:A & G SPINAL LLC
Entity Type:Organization
Organization Name:A & G SPINAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:C
Authorized Official - Last Name:WILLIAMSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:239-985-0040
Mailing Address - Street 1:8961 DANIELS CENTER DR STE 407
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33912-0316
Mailing Address - Country:US
Mailing Address - Phone:239-985-0040
Mailing Address - Fax:239-362-2272
Practice Address - Street 1:8961 DANIELS CENTER DR STE 407
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33912-0316
Practice Address - Country:US
Practice Address - Phone:239-985-0040
Practice Address - Fax:239-362-2272
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-25
Last Update Date:2023-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies