MEDICARE: MIA CONSULTING GROUP, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	310400000X	Assisted Living Facility	10314	FL

General Provider Information

NPI Number	:	1013213586
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MIA CONSULTING GROUP, INC.

Provider Business Mailing Address
First Line	:	5208 ALTON RD
Second Line	:
City	:	MIAMI BEACH
State	:	FL
Zip	:	33140-2005
Country	:	US
Telephone Number	:	187-786-4424
Fax Number	:	187-748-0880

Provider Business Practice Location Address
First Line	:	5208 ALTON RD
Second Line	:
City	:	MIAMI BEACH
State	:	FL
Zip	:	33140-2005
Country	:	US
Telephone Number	:	187-786-4424
Fax Number	:	187-748-0880

Authorized Official
Title or Position	:	CEO
Name	:	MS. CONCEPCION TRELLES BRETOS
Credential	:
Telephone Number	:	305-864-4248

Provider Enumeration Date	:	02/01/2011
Last Update Date	:	02/01/2011

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