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General NPI Number Information
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NPI Number | 1700472420
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Entity Type | Organization
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Legal Business Name | KMD MEDICAL GROUP, P.A.
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Dates
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Enumeration Date | 12/16/2020
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Last Update Date | 12/16/2020
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Provider Practice Location Address
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Address Line | 1800 NE 114TH ST APT 2001
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City | NORTH MIAMI
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State | FL
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Zip | 33181-3413
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Country | US
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Telephone | 561-901-1741
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Fax |
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Provider Business Mailing Address
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Address Line | 1800 NE 114TH ST APT 2001
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City | NORTH MIAMI
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State | FL
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Zip | 33181-3413
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Country | US
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Telephone | 561-901-1741
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. EDWARD PEARSON
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Credential | MD
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Telephone | 561-901-1741
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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