MEDICARE: DOCTORS UNITED 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	261Q00000X	Clinic/Center

General Provider Information

NPI Number	:	1114583309
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DOCTORS UNITED GROUP INC

Provider Business Mailing Address
First Line	:	714 NW 62ND ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33150-4332
Country	:	US
Telephone Number	:	305-603-8200
Fax Number	:	305-603-8461

Provider Business Practice Location Address
First Line	:	714 NW 62ND ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33150-4332
Country	:	US
Telephone Number	:	305-603-8200
Fax Number	:	305-603-8461

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	AUGUSTIN CARBON
Credential	:
Telephone Number	:	305-206-6196

Provider Enumeration Date	:	05/14/2019
Last Update Date	:	05/14/2019

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Directions to “DOCTORS UNITED GROUP INC ” Practice Location

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