Healthcare Provider Details

I. General information

NPI: 1669912184
Provider Name (Legal Business Name): WE ARE ONE MEDICAL GROUP INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/02/2017
Last Update Date: 08/02/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3169 CARTHAGE CT
ORLANDO FL
32837-9032
US

IV. Provider business mailing address

3169 CARTHAGE CT
ORLANDO FL
32837-9032
US

V. Phone/Fax

Practice location:
  • Phone: 305-495-3830
  • Fax:
Mailing address:
  • Phone: 305-495-3830
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336M0003X
TaxonomyManaged Care Organization Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: ANDRES ALEJANDRO DELGADO
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 305-495-3830