MEDICARE: INTERNAL MEDICINE ASSOCIATES OF SOUTH FLORIDA, P.A.

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	207R00000X	Internal Medicine Physician	OS000438	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1659592319
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INTERNAL MEDICINE ASSOCIATES OF SOUTH FLORIDA, P.A.

Provider Business Mailing Address
First Line	:	1380 NE MIAMI GARDENS DR STE 100
Second Line	:
City	:	NORTH MIAMI BEACH
State	:	FL
Zip	:	33179-4708
Country	:	US
Telephone Number	:	305-940-6973
Fax Number	:	305-949-6973

Provider Business Practice Location Address
First Line	:	1380 NE MIAMI GARDENS DR STE 100
Second Line	:
City	:	NORTH MIAMI BEACH
State	:	FL
Zip	:	33179-4708
Country	:	US
Telephone Number	:	305-940-6973
Fax Number	:	305-949-6973

Authorized Official
Title or Position	:	OWNER
Name	:	DR. DENNIS J OLEARY
Credential	:	D.O.
Telephone Number	:	305-940-6973

Provider Enumeration Date	:	05/01/2007
Last Update Date	:	10/22/2009

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