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General NPI Number Information
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NPI Number | 1972536571
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Entity Type | Organization
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Legal Business Name | MEDICAL GROUP OF FLORIDA INC
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Dates
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Enumeration Date | 07/08/2006
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Last Update Date | 07/25/2007
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Provider Practice Location Address
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Address Line | 831 SW 14TH AVE SUITE A
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City | MIAMI
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State | FL
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Zip | 33135-5202
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Country | US
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Telephone | 305-285-4243
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Fax | 305-285-4244
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Provider Business Mailing Address
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Address Line | 831 SW 14TH AVE SUITE A
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City | MIAMI
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State | FL
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Zip | 33135-5202
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Country | US
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Telephone | 305-285-4243
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Fax | 305-285-4244
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | DR. JULIAN NODARSE
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Credential |
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Telephone | 305-285-4243
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | ME28764
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License Number State | FL
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