Provider Demographics
NPI:1275376972
Name:ATHENS HEALTH LLC
Entity type:Organization
Organization Name:ATHENS HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER/CMO
Authorized Official - Prefix:DR
Authorized Official - First Name:LUIS
Authorized Official - Middle Name:ALBERTO
Authorized Official - Last Name:PUCHI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:917-387-6601
Mailing Address - Street 1:10401 SW 53RD ST
Mailing Address - Street 2:
Mailing Address - City:COOPER CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33328-5607
Mailing Address - Country:US
Mailing Address - Phone:917-387-6601
Mailing Address - Fax:
Practice Address - Street 1:2901 STIRLING RD STE 308
Practice Address - Street 2:
Practice Address - City:FT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33312-6531
Practice Address - Country:US
Practice Address - Phone:917-387-6601
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-18
Last Update Date:2024-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty