Healthcare Provider Details

I. General information

NPI: 1114651379
Provider Name (Legal Business Name): NMD MSO OPERATIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/13/2022
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2045 PEACHTREE RD NE STE 310
ATLANTA GA
30309-1407
US

IV. Provider business mailing address

107 WESTWARD DR UNIT 661112
MIAMI SPRINGS FL
33266-0649
US

V. Phone/Fax

Practice location:
  • Phone: 404-222-9914
  • Fax:
Mailing address:
  • Phone: 404-222-9914
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: JOSE M SANCHEZ
Title or Position: CEO
Credential:
Phone: 305-790-3775