Healthcare Provider Details
I. General information
NPI: 1134916877
Provider Name (Legal Business Name): US MEDICAL CENTER GROUP CORP
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/24/2025
Last Update Date: 08/26/2025
Certification Date: 08/26/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
777 NW 72ND AVE STE 3134
MIAMI FL
33126-3096
US
IV. Provider business mailing address
777 NW 72ND AVE STE 3134
MIAMI FL
33126-3096
US
V. Phone/Fax
- Phone: 305-707-0027
- Fax: 786-627-0027
- Phone: 305-707-0027
- Fax: 786-627-0027
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261Q00000X |
| Taxonomy | Clinic/Center |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QP2000X |
| Taxonomy | Physical Therapy Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
OSCAR
CASTELLANOS CASTELLANOS
Title or Position: PRESIDENT
Credential:
Phone: 305-707-0027