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NPI Code Detail

MEDICARE: SUPERIOR MEDICAL GROUP, CORP.

MEDICARE: SUPERIOR MEDICAL GROUP, 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
1261QM1300XMulti-Specialty Clinic/CenterHCC3935FL

General Provider Information

NPI Number : 1689622904
Entity Type Code : Organization
Provider Name (Legal Business Name) : SUPERIOR MEDICAL GROUP, CORP.
Provider Business Mailing Address
First Line : 4866 NW 7TH ST
Second Line :
City : MIAMI
State : FL
Zip : 33126-2102
Country : US
Telephone Number : 305-460-9560
Fax Number : 305-460-8985
Provider Business Practice Location Address
First Line : 4866 NW 7TH ST
Second Line :
City : MIAMI
State : FL
Zip : 33126-2102
Country : US
Telephone Number : 305-460-9560
Fax Number : 305-460-8985
Authorized Official
Title or Position : PRESIDENT
Name : YIGANIS TERESA SANTANA
Credential :
Telephone Number : 305-460-9560
Provider Enumeration Date : 05/05/2006
Last Update Date : 08/22/2020

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Directions to “SUPERIOR MEDICAL GROUP, CORP. ” Practice Location

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