Healthcare Provider Details
I. General information
NPI: 1144673294
Provider Name (Legal Business Name): DAR MEDICAL GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/13/2016
Last Update Date: 07/13/2016
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6031 TOWN COLONY DR UNIT 113
BOCA RATON FL
33433-1949
US
IV. Provider business mailing address
6031 TOWN COLONY DR UNIT 113
BOCA RATON FL
33433-1949
US
V. Phone/Fax
- Phone: 305-798-2426
- Fax: 561-431-8291
- Phone: 305-798-2426
- Fax: 561-431-8291
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208D00000X |
| Taxonomy | General Practice Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
DANIEL
RODRIGUEZ
Title or Position: DIRECTOR OF OPERATIONS
Credential:
Phone: 305-798-2426