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General NPI Number Information
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NPI Number | 1053077305
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Entity Type | Organization
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Legal Business Name | SOUTH FLORIDA DOCTORS GROUP, PLLC
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Dates
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Enumeration Date | 11/11/2021
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Last Update Date | 11/11/2021
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Provider Practice Location Address
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Address Line | 1779 N UNIVERSITY DR STE 102
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City | PEMBROKE PINES
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State | FL
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Zip | 33024-0929
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Country | US
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Telephone | 954-885-6565
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Fax | 888-727-7735
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Provider Business Mailing Address
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Address Line | 18503 PINES BLVD STE 306
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City | PEMBROKE PINES
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State | FL
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Zip | 33029-1406
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Country | US
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Telephone | 954-442-0784
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Fax | 855-840-7185
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Authorized Official
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Title or Position | OWNER
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Name | AURELIO TORRES CONSUEGRA
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Credential | MD
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Telephone | 954-442-0784
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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