MEDICARE: DO MEDICAL GROUP CORP

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
1	261QP2300X	Primary Care Clinic/Center

General Provider Information

NPI Number	:	1629718937
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DO MEDICAL GROUP CORP

Provider Business Mailing Address
First Line	:	4118 W 12TH AVE
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33012-4107
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4118 W 12TH AVE
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33012-4107
Country	:	US
Telephone Number	:	786-516-0244
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	OSMANI RAMIREZ
Credential	:
Telephone Number	:	786-516-0244

Provider Enumeration Date	:	04/01/2022
Last Update Date	:	10/06/2023

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Directions to “DO MEDICAL GROUP CORP ” Practice Location

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