MEDICARE: SPARK 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
1	111N00000X	Chiropractor

General Provider Information

NPI Number	:	1639031966
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SPARK MEDICAL GROUP

Provider Business Mailing Address
First Line	:	8801 BISCAYNE BLVD STE 105
Second Line	:
City	:	MIAMI SHORES
State	:	FL
Zip	:	33138-3381
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8801 BISCAYNE BLVD STE 105
Second Line	:
City	:	MIAMI SHORES
State	:	FL
Zip	:	33138-3381
Country	:	US
Telephone Number	:	786-558-4601
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	EUGENIO DELGADO
Credential	:
Telephone Number	:	786-284-9746

Provider Enumeration Date	:	11/25/2025
Last Update Date	:	11/25/2025

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Directions to “SPARK MEDICAL GROUP ” Practice Location

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