MEDICARE: THE HEALTH DIRECT 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	305R00000X	Preferred Provider Organization

General Provider Information

NPI Number	:	1710392451
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE HEALTH DIRECT GROUP, LLC

Provider Business Mailing Address
First Line	:	444 BRICKELL AVE
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33131-2403
Country	:	US
Telephone Number	:	305-615-2660
Fax Number	:

Provider Business Practice Location Address
First Line	:	10350 PINES BLVD STE D102
Second Line	:
City	:	PEMBROKE PINES
State	:	FL
Zip	:	33026-6051
Country	:	US
Telephone Number	:	786-286-1864
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	JOSE GORDO
Credential	:	JD
Telephone Number	:	305-615-2660

Provider Enumeration Date	:	06/20/2014
Last Update Date	:	10/18/2019

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Directions to “THE HEALTH DIRECT GROUP, LLC ” Practice Location

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