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NPI Code Detail

MEDICARE: FLORIDA PHYSICIANS GROUP INC

MEDICARE: FLORIDA PHYSICIANS GROUP INC
Medicare Provider Information

Scope of Practice

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

# Taxonomy Code Taxonomy License Number License Number State
1208D00000XGeneral Practice PhysicianME68516FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
240272OTHERFLBCBS
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1417009564
Entity Type Code : Organization
Provider Name (Legal Business Name) : FLORIDA PHYSICIANS GROUP INC
Provider Business Mailing Address
First Line : 521 RAVEN AVE
Second Line :
City : MIAMI SPRINGS
State : FL
Zip : 33166-3950
Country : US
Telephone Number : 305-824-8582
Fax Number : 305-824-4967
Provider Business Practice Location Address
First Line : 686 E 49TH ST
Second Line :
City : HIALEAH
State : FL
Zip : 33013-1964
Country : US
Telephone Number : 305-696-7921
Fax Number : 305-688-9671
Authorized Official
Title or Position : OWNER
Name : WILFRIDO BENITEZ
Credential : MD
Telephone Number : 305-696-7921
Provider Enumeration Date : 01/17/2007
Last Update Date : 07/30/2020

Similar Medicare Providers

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1912189192 — FLORIDA PHYSICIANS GROUP INC
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1881857100 — YANSSEL DELGADO DPM PA
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Directions to “FLORIDA PHYSICIANS GROUP INC ” Practice Location

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