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General NPI Number Information
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NPI Number | 1932185238
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Entity Type | Organization
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Legal Business Name | PHYSICIANS GROUP OF SOUTH FLORIDA PA
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Dates
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Enumeration Date | 12/19/2005
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Last Update Date | 08/27/2024
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Provider Practice Location Address
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Address Line | 1801 NE 123RD ST STE 405
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City | NORTH MIAMI
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State | FL
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Zip | 33181-2884
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Country | US
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Telephone | 305-674-5925
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Fax | 305-674-5927
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Provider Business Mailing Address
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Address Line | 4300 ALTON RD #810
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City | MIAMI BEACH
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State | FL
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Zip | 33140-2800
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Country | US
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Telephone | 305-674-5925
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Fax | 305-674-5927
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Authorized Official
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Title or Position | COO
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Name | JANE S COHEN
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Credential | MD
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Telephone | 305-674-5925
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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 | ME39020
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | ME39020
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License Number State | FL
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