MEDICARE: VALUE MD GROUP CORP

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	208D00000X	General Practice Physician

General Provider Information

NPI Number	:	1366742967
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VALUE MD GROUP CORP

Provider Business Mailing Address
First Line	:	6400 SW 4TH ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33144-3704
Country	:	US
Telephone Number	:	561-424-1375
Fax Number	:

Provider Business Practice Location Address
First Line	:	1964 S CONGRESS AVE
Second Line	:
City	:	PALM SPRINGS
State	:	FL
Zip	:	33406-6674
Country	:	US
Telephone Number	:	561-424-1375
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	NIVARDO PARRA
Credential	:
Telephone Number	:	561-424-1375

Provider Enumeration Date	:	10/28/2010
Last Update Date	:	10/28/2010

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Directions to “VALUE MD GROUP CORP ” Practice Location

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