Healthcare Provider Details

I. General information

NPI: 1124267422
Provider Name (Legal Business Name): NEW EGE GROUP, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/10/2009
Last Update Date: 02/10/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6001 NW 153RD ST SUITE E
MIAMI LAKES FL
33014-2419
US

IV. Provider business mailing address

6001 NW 153RD ST SUITE E
MIAMI LAKES FL
33014-2419
US

V. Phone/Fax

Practice location:
  • Phone: 786-314-1737
  • Fax: 305-675-0110
Mailing address:
  • Phone: 786-314-1737
  • Fax: 305-675-0110

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NR0200X
TaxonomyRadiology Chiropractor
License Number
License Number State

VIII. Authorized Official

Name: SANDOR SUAREZ
Title or Position: PRESIDENT
Credential:
Phone: 786-314-1737