AGUSTIN A. BURGOS, M.D., P.A.
Radiology at 82 Ave, Fort Lauderdale, FL

License number
Florida ME78600
Category
Radiology
Type
Surgery
Owner
Name: AGUSTIN A BURGOS MD
Title: OWNER
Phone: (954) 472-1354
Address
Address
201 NW 82Nd Ave SUITE 405, Fort Lauderdale, FL 33324
National Provider ID: 1902049760
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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AGUSTIN BURGOS, M.D., PA

201 NW 82 Ave STE 405, Fort Lauderdale, FL 33324

Status:
Inactive
Registration:
Mar 13, 2002
State ID:
P04000063378
Business type:
Florida Profit Corporation
President, Treasurer, Director, Secretary, Vice President:
Agustin M.d. Burgos President, Treasurer, Director, Secretary, Vice President, inactive, 201 NW 82 Ave STE 405, Fort Lauderdale, FL 33324 (Physical)
Agent:
Burgos, Agustin,2070 Borealis Way, Fort Lauderdale, FL 33327 (Physical)
EIN:
20-1035321

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