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General NPI Number Information
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NPI Number | 1225320054
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Entity Type | Organization
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Legal Business Name | MEDGROUP MEDICAL CENTER LLC
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Dates
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Enumeration Date | 05/12/2011
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Last Update Date | 04/01/2025
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Provider Practice Location Address
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Address Line | 5200 SW 8TH ST SUITE 150
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City | CORAL GABLES
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State | FL
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Zip | 33134-2300
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Country | US
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Telephone | 305-250-5600
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Fax | 305-250-5688
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Provider Business Mailing Address
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Address Line | 5200 SW 8TH ST SUITE 150
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City | CORAL GABLES
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State | FL
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Zip | 33134-2300
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Country | US
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Telephone | 305-761-6685
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Fax | 305-250-5688
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Authorized Official
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Title or Position | MGRM
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Name | SANTIAGO VERA
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Credential |
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Telephone | 305-250-5600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | AHCA HCC 9140
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License Number State | FL
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