Aegle Group LLC
Organization Active NPI Exclusive Provider Organization · Lynn Haven, FL
NPI 1053809574 · NPPES record last updated Oct 29, 2019
Key facts
- NPI
- 1053809574
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Exclusive Provider Organization 302F00000X
- Legal business name
- AEGLE GROUP LLC
- Practice address
- 3003 S Highway 77 Ste F
Lynn Haven, FL 32444-5627 - Phone
- (850) 250-5757
- NPI assigned
- Apr 30, 2018
- Organization subpart
- No
Authorized official
- Name
- Mr. Michael John Maclaren, MHHA
- Title
- President
- Phone
- (850) 250-5757
National Provider Directory
Locations
3003 S Highway 77
Ste F
Lynn Haven, FL 32444
Phone (850) 250-5757
1615 Florida Ave
Panama City, FL 32405
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Exclusive Provider Organization | 302F00000X | Yes |
Addresses
Primary practice location
3003 S Highway 77 Ste F
Lynn Haven, FL 32444-5627
Mailing address
3003 S Highway 77 Ste F
Lynn Haven, FL 32444-5627
Phone (850) 250-5757
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 710189 | Medicaid | FL |
Other providers in Lynn Haven, FL
- Adams Pharmacy Inc
- Alexandra Adams
- David Michael Adams
- Mary Sue Adams
- Nathan Adams
- Affinity Wellness Corporations
- Aziz Ahmad
- Verel Marie Ahye
- Malvinder S Ajit
- All Too Well Therapy LLC
All providers in Lynn Haven, FL · Exclusive Provider Organization in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 29, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.