MEDICARE: ACN PHYSICIANS GROUP CORP

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	207Q00000X	Family Medicine Physician
2	2084P0800X	Psychiatry Physician
3	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)
4	261QM1300X	Multi-Specialty Clinic/Center

Other Identifiers

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

General Provider Information

NPI Number	:	1619296308
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ACN PHYSICIANS GROUP CORP

Provider Business Mailing Address
First Line	:	7490 SW 23RD ST STE 201
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33155-1417
Country	:	US
Telephone Number	:	786-953-8221
Fax Number	:	786-953-7514

Provider Business Practice Location Address
First Line	:	7490 SW 23RD ST STE 201
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33155-1417
Country	:	US
Telephone Number	:	786-953-8221
Fax Number	:	786-953-7514

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. VLADIMIR SANTOS
Credential	:	MD
Telephone Number	:	786-953-8221

Provider Enumeration Date	:	05/20/2010
Last Update Date	:	08/07/2023

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