Agewll LLC
Organization Active NPI Family Medicine Physician · Weston, FL
NPI 1477403442 · NPPES record last updated Jan 30, 2026
Key facts
- NPI
- 1477403442
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- Legal business name
- AGEWLL LLC
- Practice address
- 2645 Executive Park Dr
Weston, FL 33331-3624 - Phone
- (954) 361-1065
- Fax
- (954) 317-9915
- NPI assigned
- Jan 30, 2026
- Organization subpart
- No
Authorized official
- Name
- Luis Suarez
- Title
- Owner/Manager
- Phone
- (954) 361-1065
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | Yes |
Addresses
Primary practice location
2645 Executive Park Dr
Weston, FL 33331-3624
Mailing address
2645 Executive Park Dr
Weston, FL 33331-3624
Phone (954) 361-1065
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 30, 2026. 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.