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General NPI Number Information
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NPI Number | 1710238381
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Entity Type | Organization
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Legal Business Name | SEASONS MEDICAL GROUP OF FLORIDA PA
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Dates
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Enumeration Date | 09/24/2012
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Last Update Date | 02/17/2023
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Provider Practice Location Address
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Address Line | 5200 NE 2ND AVE FL 3
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City | MIAMI
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State | FL
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Zip | 33137-2706
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Country | US
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Telephone | 877-731-9299
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Fax |
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Provider Business Mailing Address
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Address Line | 6400 SHAFER CT STE 300A
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City | ROSEMONT
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State | IL
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Zip | 60018-4914
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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 | FINANCE DIRECTOR
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Name | CARRIE BILL
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Credential |
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Telephone | 847-692-1148
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207PH0002X
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Taxonomy Name | Hospice and Palliative Medicine (Emergency Medicine) Physician
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License Number |
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License Number State |
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Taxonomy #2
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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 |
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Taxonomy #3
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Taxonomy Code | 207QH0002X
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Taxonomy Name | Hospice and Palliative Medicine (Family Medicine) Physician
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License Number |
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License Number State |
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Taxonomy #4
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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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