Provider Demographics
NPI:1740315167
Name:DD AMERICAN GROUP INC.
Entity type:Organization
Organization Name:DD AMERICAN GROUP INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LAZARO
Authorized Official - Middle Name:
Authorized Official - Last Name:VIGOA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-434-6607
Mailing Address - Street 1:2590 FOREST HILL BLVD
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33406-5929
Mailing Address - Country:US
Mailing Address - Phone:561-434-6607
Mailing Address - Fax:
Practice Address - Street 1:2590 FOREST HILL BLVD
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33406-5929
Practice Address - Country:US
Practice Address - Phone:561-434-6607
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHCC7516174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty