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General NPI Number Information
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NPI Number | 1710392451
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Entity Type | Organization
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Legal Business Name | THE HEALTH DIRECT GROUP, LLC
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Dates
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Enumeration Date | 06/20/2014
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Last Update Date | 10/18/2019
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Provider Practice Location Address
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Address Line | 10350 PINES BLVD STE D102
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City | PEMBROKE PINES
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State | FL
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Zip | 33026-6051
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Country | US
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Telephone | 786-286-1864
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Fax |
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Provider Business Mailing Address
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Address Line | 444 BRICKELL AVE
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City | MIAMI
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State | FL
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Zip | 33131-2403
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Country | US
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Telephone | 305-615-2660
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | JOSE GORDO
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Credential | JD
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Telephone | 305-615-2660
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 305R00000X
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Taxonomy Name | Preferred Provider Organization
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License Number |
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License Number State |
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