Healthcare Provider Details

I. General information

NPI: 1790044287
Provider Name (Legal Business Name): ACCESS MEDICAL GROUP OF OPA-LOCKA, LLC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/03/2012
Last Update Date: 05/25/2023
Certification Date: 05/25/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

321 OPA LOCKA BLVD
OPA LOCKA FL
33054-3526
US

IV. Provider business mailing address

6100 BLUE LAGOON DR SUITE 365
MIAMI FL
33126-2079
US

V. Phone/Fax

Practice location:
  • Phone: 786-476-3333
  • Fax: 786-476-3334
Mailing address:
  • Phone: 786-322-7333
  • Fax: 786-322-7329

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. RAYNY RAMIREZ
Title or Position: PRESIDENT
Credential:
Phone: 786-322-7333