Healthcare Provider Details

I. General information

NPI: 1831778554
Provider Name (Legal Business Name): THE MEDICAL GROUP OF SOUTH FLORIDA, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/08/2021
Last Update Date: 04/08/2021
Certification Date: 04/08/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

671 GOODLETTE-FRANK RD N STE 230
NAPLES FL
34102-5615
US

IV. Provider business mailing address

1094 MILITARY TRL
JUPITER FL
33458-7021
US

V. Phone/Fax

Practice location:
  • Phone: 239-304-9501
  • Fax: 239-692-8486
Mailing address:
  • Phone: 561-622-6111
  • Fax: 561-246-3721

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: JOSHUA K SMITH
Title or Position: CEO/OWNER
Credential: DC
Phone: 561-622-6111