MEDICARE: MIAMI BEACH MEDICAL CONSULTANTS, LLC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	363LF0000X	Family Nurse Practitioner
2	207Q00000X	Family Medicine Physician
3	208000000X	Pediatrics Physician
4	208D00000X	General Practice Physician

General Provider Information

NPI Number	:	1285340083
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MIAMI BEACH MEDICAL CONSULTANTS, LLC.

Provider Business Mailing Address
First Line	:	1400 NW 107TH AVE STE 500
Second Line	:
City	:	SWEETWATER
State	:	FL
Zip	:	33172-2746
Country	:	US
Telephone Number	:	305-534-0076
Fax Number	:

Provider Business Practice Location Address
First Line	:	7444 PALM RIVER RD
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33619-4128
Country	:	US
Telephone Number	:	813-392-1894
Fax Number	:

Authorized Official
Title or Position	:	COM
Name	:	JOSE D SUAREZ
Credential	:
Telephone Number	:	305-534-0076

Provider Enumeration Date	:	01/25/2023
Last Update Date	:	10/30/2023

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