MEDICARE: PRIME MEDICAL GROUP

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	:	1922437573
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PRIME MEDICAL GROUP

Provider Business Mailing Address
First Line	:	1452 N KROME AVE
Second Line	:	101-I
City	:	FLORIDA CITY
State	:	FL
Zip	:	33034-2440
Country	:	US
Telephone Number	:	305-316-2047
Fax Number	:	786-504-3364

Provider Business Practice Location Address
First Line	:	1452 N KROME AVE
Second Line	:	101-I
City	:	FLORIDA CITY
State	:	FL
Zip	:	33034-2440
Country	:	US
Telephone Number	:	305-316-2047
Fax Number	:	786-504-3364

Authorized Official
Title or Position	:	PRESIDENT
Name	:	IGNACIO GARCIA-ALEMAN
Credential	:
Telephone Number	:	305-316-2047

Provider Enumeration Date	:	11/04/2013
Last Update Date	:	11/04/2013

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Directions to “PRIME MEDICAL GROUP ” Practice Location

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