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NPI Code Detail

MEDICARE: ASSOCIATESMD MEDICAL GROUP INC

MEDICARE: ASSOCIATESMD 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
1261QP2300XPrimary Care Clinic/Center

General Provider Information

NPI Number : 1558151399
Entity Type Code : Organization
Provider Name (Legal Business Name) : ASSOCIATESMD MEDICAL GROUP INC
Provider Business Mailing Address
First Line : 4780 SW 64TH AVE STE 103
Second Line :
City : DAVIE
State : FL
Zip : 33314-4400
Country : US
Telephone Number : 954-434-1705
Fax Number :
Provider Business Practice Location Address
First Line : 1437 S FEDERAL HWY
Second Line :
City : DANIA BEACH
State : FL
Zip : 33004-4348
Country : US
Telephone Number : 954-399-9941
Fax Number :
Authorized Official
Title or Position : CEO
Name : LUIS FELIPE LAFRATTA
Credential :
Telephone Number : 954-434-1705
Provider Enumeration Date : 05/06/2025
Last Update Date : 05/06/2025

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Directions to “ASSOCIATESMD MEDICAL GROUP INC ” Practice Location

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