Provider Demographics
NPI:1811222797
Name:CAG MEDICAL SERVICES INC
Entity Type:Organization
Organization Name:CAG MEDICAL SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CLIFFORD
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:GREENBERG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:239-560-1655
Mailing Address - Street 1:1415 MARIPOSA CIR
Mailing Address - Street 2:SUITE 204
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34105-7272
Mailing Address - Country:US
Mailing Address - Phone:239-560-1655
Mailing Address - Fax:239-793-3822
Practice Address - Street 1:1415 MARIPOSA CIR
Practice Address - Street 2:SUITE 204
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34105-7272
Practice Address - Country:US
Practice Address - Phone:239-560-1655
Practice Address - Fax:239-793-3822
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-09
Last Update Date:2009-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME92387207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLME92387OtherMEDICAL LICENSE