MEDICARE: STEWARD MEDICAL 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	2084N0400X	Neurology Physician
2	207RC0000X	Cardiovascular Disease Physician

General Provider Information

NPI Number	:	1417663154
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STEWARD MEDICAL GROUP, INC

Provider Business Mailing Address
First Line	:	9 GALEN ST
Second Line	:
City	:	WATERTOWN
State	:	MA
Zip	:	02472-4515
Country	:	US
Telephone Number	:	617-562-5628
Fax Number	:

Provider Business Practice Location Address
First Line	:	9400 NW 12TH AVE STE 4
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33150-2026
Country	:	US
Telephone Number	:	305-932-2463
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT OF SMG
Name	:	AMY MARIE GUAY
Credential	:
Telephone Number	:	469-341-8848

Provider Enumeration Date	:	01/26/2023
Last Update Date	:	01/26/2023

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Directions to “STEWARD MEDICAL GROUP, INC ” Practice Location

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