Healthcare Provider Details

I. General information

NPI: 1922787688
Provider Name (Legal Business Name): LOYAL MEDICAL GROUP INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/11/2023
Last Update Date: 03/25/2025
Certification Date: 03/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8395 W OAKLAND PARK BLVD STE C
SUNRISE FL
33351-7346
US

IV. Provider business mailing address

8391 W OAKLAND PARK BLVD
SUNRISE FL
33351-7307
US

V. Phone/Fax

Practice location:
  • Phone: 954-335-6925
  • Fax: 954-400-3550
Mailing address:
  • Phone: 954-335-6925
  • Fax: 954-400-3550

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 Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. ILIT HANNA OSHER
Title or Position: PRESIDENT
Credential:
Phone: 954-335-6925