Healthcare Provider Details

I. General information

NPI: 1033642111
Provider Name (Legal Business Name): AARON MEDICAL GROUP CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/06/2017
Last Update Date: 04/06/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19509 NW 57TH AVE
MIAMI GARDENS FL
33055-4709
US

IV. Provider business mailing address

19509 NW 57TH AVE
MIAMI GARDENS FL
33055-4709
US

V. Phone/Fax

Practice location:
  • Phone: 754-465-3003
  • Fax: 866-552-0934
Mailing address:
  • Phone: 754-465-3003
  • Fax: 866-552-0934

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JORGE E GARRIGA
Title or Position: PRESIDENT
Credential:
Phone: 754-465-3003