Healthcare Provider Details

I. General information

NPI: 1750858783
Provider Name (Legal Business Name): EFERRED PARTNERS GROUP CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/29/2018
Last Update Date: 10/29/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

99 NW 183RD ST STE 241E
MIAMI GARDENS FL
33169-4551
US

IV. Provider business mailing address

99 NW 183RD ST STE 241E
MIAMI GARDENS FL
33169-4551
US

V. Phone/Fax

Practice location:
  • Phone: 786-555-0922
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: ARMANDO PINEDA
Title or Position: PRESIDENT
Credential:
Phone: 786-555-0922