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NPI Code Detail

MEDICARE: PHYSICIAN SPECIALTY GROUP INC

MEDICARE: PHYSICIAN SPECIALTY 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
1207W00000XOphthalmology PhysicianME 30093FL

General Provider Information

NPI Number : 1609820059
Entity Type Code : Organization
Provider Name (Legal Business Name) : PHYSICIAN SPECIALTY GROUP INC
Provider Business Mailing Address
First Line : 7949 NW 2ND ST
Second Line :
City : MIAMI
State : FL
Zip : 33126-8000
Country : US
Telephone Number : 305-263-9050
Fax Number : 305-269-7171
Provider Business Practice Location Address
First Line : 7949 NW 2ND ST
Second Line :
City : MIAMI
State : FL
Zip : 33126-8000
Country : US
Telephone Number : 305-263-9050
Fax Number : 305-269-7171
Authorized Official
Title or Position : OWNER
Name : JOSE ALLENDE
Credential :
Telephone Number : 305-263-9050
Provider Enumeration Date : 05/20/2006
Last Update Date : 04/15/2011

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Directions to “PHYSICIAN SPECIALTY GROUP INC ” Practice Location

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