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NPI Code Detail

MEDICARE: A AND A MEDICAL GROUP

MEDICARE: A AND A MEDICAL GROUP
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
1208D00000XGeneral Practice PhysicianHCC6859FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1595400-4OTHERFLOCCUPATIONAL LICENSE

General Provider Information

NPI Number : 1396857926
Entity Type Code : Organization
Provider Name (Legal Business Name) : A AND A MEDICAL GROUP
Provider Business Mailing Address
First Line : 1149 SW 27TH AVE
Second Line : SUITE 203
City : MIAMI
State : FL
Zip : 33135-4758
Country : US
Telephone Number : 305-646-1000
Fax Number : 305-646-1656
Provider Business Practice Location Address
First Line : 1149 SW 27TH AVE
Second Line : SUITE 203
City : MIAMI
State : FL
Zip : 33135-4758
Country : US
Telephone Number : 305-646-1000
Fax Number : 305-646-1656
Authorized Official
Title or Position : PRESIDENT
Name : ALFREDO GONZALEZ
Credential :
Telephone Number : 305-646-1000
Provider Enumeration Date : 08/31/2006
Last Update Date : 06/13/2008

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Directions to “A AND A MEDICAL GROUP ” Practice Location

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