MEDICARE: INFINITE SPECIALTY MEDICAL SERVICES FL PLLC

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	207Q00000X	Family Medicine Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1457011165
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INFINITE SPECIALTY MEDICAL SERVICES FL PLLC

Provider Business Mailing Address
First Line	:	250 SKILLMAN ST STE 202
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11205-1218
Country	:	US
Telephone Number	:	718-534-0689
Fax Number	:

Provider Business Practice Location Address
First Line	:	16650 W DIXIE HWY
Second Line	:
City	:	NORTH MIAMI BEACH
State	:	FL
Zip	:	33160-3713
Country	:	US
Telephone Number	:	718-534-0689
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	REKHA BHANDARI
Credential	:
Telephone Number	:	718-534-0689

Provider Enumeration Date	:	12/21/2021
Last Update Date	:	12/21/2021

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