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General NPI Number Information
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NPI Number | 1366742967
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Entity Type | Organization
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Legal Business Name | VALUE MD GROUP CORP
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Dates
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Enumeration Date | 10/28/2010
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Last Update Date | 10/28/2010
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Provider Practice Location Address
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Address Line | 1964 S CONGRESS AVE
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City | PALM SPRINGS
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State | FL
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Zip | 33406-6674
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Country | US
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Telephone | 561-424-1375
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Fax |
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Provider Business Mailing Address
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Address Line | 6400 SW 4TH ST
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City | MIAMI
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State | FL
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Zip | 33144-3704
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Country | US
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Telephone | 561-424-1375
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | NIVARDO PARRA
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Credential |
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Telephone | 561-424-1375
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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