Healthcare Provider Details

I. General information

NPI: 1982944898
Provider Name (Legal Business Name): ASTAR MEDICAL GROUP INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/01/2013
Last Update Date: 10/31/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 NW 170TH STREET SUITE 105
NORTH MIAMI BEACH FL
33169
US

IV. Provider business mailing address

100 NW 170TH STREET SUITE 105
NORTH MIAMI BEACH FL
33169
US

V. Phone/Fax

Practice location:
  • Phone: 305-653-6856
  • Fax: 305-653-6838
Mailing address:
  • Phone: 305-653-6856
  • Fax: 305-653-6838

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State

VIII. Authorized Official

Name: VICTOR BEHAR
Title or Position: CEO
Credential:
Phone: 786-271-3697