Healthcare Provider Details
I. General information
NPI: 1427330091
Provider Name (Legal Business Name): ACCESS MEDICAL GROUP OF HIALEAH, LLC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/09/2011
Last Update Date: 05/25/2023
Certification Date: 05/25/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3805 W 20TH AVE STE 105
HIALEAH FL
33012-4532
US
IV. Provider business mailing address
6100 BLUE LAGOON DR SUITE 365
MIAMI FL
33126-2079
US
V. Phone/Fax
- Phone: 305-557-2277
- Fax: 305-557-2278
- Phone: 786-322-7333
- Fax: 786-322-7329
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
RAYNY
RAMIREZ
Title or Position: PRESIDENT
Credential:
Phone: 786-322-7333