Provider Demographics
NPI:1053779728
Name:DE LAS CAGIGAS, ANNALIE
Entity type:Individual
Prefix:
First Name:ANNALIE
Middle Name:
Last Name:DE LAS CAGIGAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2960 S JOG RD
Mailing Address - Street 2:
Mailing Address - City:GREENACRES
Mailing Address - State:FL
Mailing Address - Zip Code:33467-2002
Mailing Address - Country:US
Mailing Address - Phone:561-232-8298
Mailing Address - Fax:
Practice Address - Street 1:2960 S JOG RD
Practice Address - Street 2:
Practice Address - City:GREENACRES
Practice Address - State:FL
Practice Address - Zip Code:33467-2002
Practice Address - Country:US
Practice Address - Phone:561-232-8298
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-09
Last Update Date:2016-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care