MEDICARE: THE MEDICAL GROUP OF SOUTH FLORIDA, 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	261QM1300X	Multi-Specialty Clinic/Center

General Provider Information

NPI Number	:	1184384752
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE MEDICAL GROUP OF SOUTH FLORIDA, INC

Provider Business Mailing Address
First Line	:	1094 MILITARY TRL
Second Line	:
City	:	JUPITER
State	:	FL
Zip	:	33458-7021
Country	:	US
Telephone Number	:	561-622-6111
Fax Number	:	561-246-3721

Provider Business Practice Location Address
First Line	:	801 NORTHPOINT PKWY STE 95
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33407-1812
Country	:	US
Telephone Number	:	561-255-3131
Fax Number	:	855-215-9930

Authorized Official
Title or Position	:	CEO
Name	:	DR. JOSHUA K SMITH
Credential	:	DC
Telephone Number	:	561-622-6111

Provider Enumeration Date	:	12/23/2021
Last Update Date	:	12/23/2021

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