Healthcare Provider Details

I. General information

NPI: 1689918989
Provider Name (Legal Business Name): NEW MEDICAL GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/27/2012
Last Update Date: 11/27/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4001 NW 97TH AVE STE 101B
DORAL FL
33178-2384
US

IV. Provider business mailing address

4001 NW 97TH AVE STE 101B
DORAL FL
33178-2384
US

V. Phone/Fax

Practice location:
  • Phone: 305-436-7988
  • Fax: 305-436-3021
Mailing address:
  • Phone: 305-436-7988
  • Fax: 305-436-3021

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number StateNULL

VIII. Authorized Official

Name: MRS. LEDIA M ZAPATA
Title or Position: PRESIDENT
Credential:
Phone: 305-435-7988