MEDICARE: ETERNITY MEDICAL GROUP CORP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	261Q00000X	Clinic/Center
2	261QM0850X	Adult Mental Health Clinic/Center
3	261QP2300X	Primary Care Clinic/Center
4	261QM1300X	Multi-Specialty Clinic/Center

General Provider Information

NPI Number	:	1649108515
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ETERNITY MEDICAL GROUP CORP

Provider Business Mailing Address
First Line	:	900 SW 8TH ST STE C1
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33130-3756
Country	:	US
Telephone Number	:	786-332-3136
Fax Number	:	305-726-0013

Provider Business Practice Location Address
First Line	:	900 SW 8TH ST STE C1
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33130-3756
Country	:	US
Telephone Number	:	786-332-3136
Fax Number	:	305-726-0013

Authorized Official
Title or Position	:	OWNER/CEO
Name	:	LUIS AGUILAR
Credential	:
Telephone Number	:	786-332-3136

Provider Enumeration Date	:	05/11/2026
Last Update Date	:	05/11/2026

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Directions to “ETERNITY MEDICAL GROUP CORP ” Practice Location

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