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General NPI Number Information
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NPI Number | 1639031966
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Entity Type | Organization
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Legal Business Name | SPARK MEDICAL GROUP
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Dates
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Enumeration Date | 11/25/2025
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Last Update Date | 11/25/2025
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Provider Practice Location Address
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Address Line | 8801 BISCAYNE BLVD STE 105
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City | MIAMI SHORES
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State | FL
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Zip | 33138-3381
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Country | US
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Telephone | 786-558-4601
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Fax |
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Provider Business Mailing Address
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Address Line | 8801 BISCAYNE BLVD STE 105
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City | MIAMI SHORES
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State | FL
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Zip | 33138-3381
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | EUGENIO DELGADO
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Credential |
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Telephone | 786-284-9746
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number |
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License Number State |
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