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General NPI Number Information
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NPI Number | 1386893345
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Entity Type | Organization
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Legal Business Name | MMG SUPPORT SERVICES, INC.
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Dates
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Enumeration Date | 09/15/2008
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Last Update Date | 09/15/2008
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Provider Practice Location Address
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Address Line | 4001 SW 144TH PL
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City | MIAMI
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State | FL
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Zip | 33175-7844
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Country | US
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Telephone | 305-968-1337
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Fax | 305-226-7016
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Provider Business Mailing Address
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Address Line | 4001 SW 144TH PL
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City | MIAMI
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State | FL
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Zip | 33175-7844
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Country | US
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Telephone | 305-968-1337
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Fax | 305-226-7016
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Authorized Official
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Title or Position | DIRECTOR
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Name | MS. MARTHA M. GONZALEZ
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Credential | CSC
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Telephone | 305-968-1337
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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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