Healthcare Provider Details

I. General information

NPI: 1982494589
Provider Name (Legal Business Name): ASSOCIATESMD MEDICAL GROUP INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/08/2025
Last Update Date: 05/08/2025
Certification Date: 05/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1604 TOWN CENTER BLVD STE 4B-C
WESTON FL
33326-3640
US

IV. Provider business mailing address

4780 SW 64TH AVE STE 103
DAVIE FL
33314-4400
US

V. Phone/Fax

Practice location:
  • Phone: 954-384-1800
  • Fax:
Mailing address:
  • Phone: 954-434-1705
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: LUIS FELIPE LAFRATTA
Title or Position: CEO
Credential:
Phone: 954-434-1705