MEDICARE: HOMS MEDICAL 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
1	207R00000X	Internal Medicine Physician

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	:	1669137410
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOMS MEDICAL GROUP, INC.

Provider Business Mailing Address
First Line	:	106 S FEDERAL HWY APT 650
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33301-4332
Country	:	US
Telephone Number	:	312-218-3450
Fax Number	:

Provider Business Practice Location Address
First Line	:	106 S FEDERAL HWY APT 650
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33301-4332
Country	:	US
Telephone Number	:	312-218-3450
Fax Number	:

Authorized Official
Title or Position	:	CREDENTIALING DIRECTOR
Name	:	JORGE GARCIA
Credential	:
Telephone Number	:	305-606-0337

Provider Enumeration Date	:	11/07/2021
Last Update Date	:	11/07/2021

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