Healthcare Provider Details

I. General information

NPI: 1932920170
Provider Name (Legal Business Name): ANT MEDICAL GROUP, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/21/2024
Last Update Date: 10/21/2024
Certification Date: 10/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4960 SW 72ND AVE STE 400
MIAMI FL
33155-5550
US

IV. Provider business mailing address

4960 SW 72ND AVE STE 400
MIAMI FL
33155-5550
US

V. Phone/Fax

Practice location:
  • Phone: 305-972-3587
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2084S0012X
TaxonomySleep Medicine (Psychiatry & Neurology) Physician
License Number
License Number State

VIII. Authorized Official

Name: RAKEESH SOOD
Title or Position: PRESIDENT
Credential: MD
Phone: 305-972-3587