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NPI Code Detail

MEDICARE: MG CENTER COMPANIA CORP

MEDICARE: MG CENTER COMPANIA CORP
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
1261Q00000XClinic/Center

General Provider Information

NPI Number : 1649064148
Entity Type Code : Organization
Provider Name (Legal Business Name) : MG CENTER COMPANIA CORP
Provider Business Mailing Address
First Line : 16800 NW 2ND AVE STE 108
Second Line :
City : NORTH MIAMI BEACH
State : FL
Zip : 33169-5509
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 16800 NW 2ND AVE STE 108
Second Line :
City : NORTH MIAMI BEACH
State : FL
Zip : 33169-5509
Country : US
Telephone Number : 561-321-3533
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : MICHAEL A SIUTA
Credential : M.D
Telephone Number : 561-321-3533
Provider Enumeration Date : 04/08/2025
Last Update Date : 04/08/2025

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Directions to “MG CENTER COMPANIA CORP ” Practice Location

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