MEDICARE: BERMUDEZ MEDICAL GROUP, LLC.

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	207QA0505X	Adult 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	:	1700396637
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BERMUDEZ MEDICAL GROUP, LLC.

Provider Business Mailing Address
First Line	:	2601 DAVIE BLVD STE B
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33312-3029
Country	:	US
Telephone Number	:	305-300-5501
Fax Number	:	305-383-7408

Provider Business Practice Location Address
First Line	:	2601 DAVIE BLVD STE B
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33312-3029
Country	:	US
Telephone Number	:	305-300-5501
Fax Number	:	305-383-7408

Authorized Official
Title or Position	:	M.D.
Name	:	LIDIA ROSA BERMUDEZ
Credential	:	M.D.
Telephone Number	:	305-300-5501

Provider Enumeration Date	:	10/05/2017
Last Update Date	:	09/19/2025

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