MEDICARE: SOFL PHYSICIANS GROUP LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	133N00000X	Nutritionist
2	225700000X	Massage Therapist
3	225X00000X	Occupational Therapist
4	2084P0802X	Addiction Psychiatry Physician
5	2084A0401X	Addiction Medicine (Psychiatry & Neurology) Physician

General Provider Information

NPI Number	:	1841655594
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOFL PHYSICIANS GROUP LLC

Provider Business Mailing Address
First Line	:	4045 SHERIDAN AVE. #236
Second Line	:
City	:	MIAMI BEACH
State	:	FL
Zip	:	33140
Country	:	US
Telephone Number	:	786-708-0193
Fax Number	:

Provider Business Practice Location Address
First Line	:	4045 SHERIDAN AVE. #236
Second Line	:
City	:	MIAMI BEACH
State	:	FL
Zip	:	33140
Country	:	US
Telephone Number	:	786-708-0193
Fax Number	:

Authorized Official
Title or Position	:	FINANCE DIRECTOR
Name	:	KAREN BARRY
Credential	:
Telephone Number	:	786-708-0193

Provider Enumeration Date	:	12/23/2015
Last Update Date	:	11/02/2016

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Directions to “SOFL PHYSICIANS GROUP LLC ” Practice Location

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