Healthcare Provider Details

I. General information

NPI: 1609613322
Provider Name (Legal Business Name): HEALTH LINK GROUP, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/10/2024
Last Update Date: 07/10/2024
Certification Date: 07/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4615 ALTON RD
MIAMI BEACH FL
33140-2806
US

IV. Provider business mailing address

4615 ALTON RD
MIAMI BEACH FL
33140-2806
US

V. Phone/Fax

Practice location:
  • Phone: 410-977-3009
  • Fax:
Mailing address:
  • Phone: 410-977-3009
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code302R00000X
TaxonomyHealth Maintenance Organization
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code305R00000X
TaxonomyPreferred Provider Organization
License Number
License Number State

VIII. Authorized Official

Name: LENA NIKOLNIKOV
Title or Position: MGR
Credential:
Phone: 410-977-3009