Organization · NPI-2

Agave Family Medicine

Family Medicine · Tucson, AZ

NPI number1407809387
StatusActive
Last updated in NPPESAug 22, 2020

Details

NPI
1407809387
Entity type
Organization (NPI-2)
Legal business name
Agave Family Medicine
Organization subpart
No
Enumeration date
May 19, 2006
Last updated
Aug 22, 2020

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207Q00000X Family Medicine33407AZYes

Practice location

8710 N Thornydale Rd
Ste 160
Tucson, AZ 85742-5031

Phone 520-744-2441

Mailing address

Po Box 43100
Tucson, AZ 85733-3100

Phone 520-722-3777

Authorized official

Charles A Michieli
President
5207442441

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