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General NPI Number Information
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NPI Number | 1336574201
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Entity Type | Organization
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Legal Business Name | PRIMENET MEDICAL GROUP, INC.
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Dates
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Enumeration Date | 09/10/2013
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Last Update Date | 05/26/2015
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Provider Practice Location Address
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Address Line | 9000 SW 137TH AVE SUITE 115
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City | MIAMI
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State | FL
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Zip | 33186-1435
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Country | US
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Telephone | 305-387-1981
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Fax | 305-387-1939
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Provider Business Mailing Address
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Address Line | 9000 SW 137TH AVE SUITE 115
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City | MIAMI
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State | FL
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Zip | 33186-1435
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Country | US
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Telephone | 305-387-1981
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Fax | 305-387-1939
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. MAGGIE TORRES
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Credential |
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Telephone | 954-983-1220
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State | FL
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