MEDICARE: MD OFFICE DIRECT 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
1	208D00000X	General Practice Physician	ME86713	FL

General Provider Information

NPI Number	:	1700078540
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MD OFFICE DIRECT INC

Provider Business Mailing Address
First Line	:	1420 SW 1ST ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33135-2203
Country	:	US
Telephone Number	:	305-649-0278
Fax Number	:

Provider Business Practice Location Address
First Line	:	1420 SW 1ST ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33135-2203
Country	:	US
Telephone Number	:	305-649-0278
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	JORGE VALIDO
Credential	:	MD
Telephone Number	:	305-649-0277

Provider Enumeration Date	:	08/15/2007
Last Update Date	:	08/15/2007

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