MEDICARE: MEDICAL GLOBAL CENTER 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	208D00000X	General Practice Physician	HCC7628	FL

General Provider Information

NPI Number	:	1730396334
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MEDICAL GLOBAL CENTER INC

Provider Business Mailing Address
First Line	:	2167 W FLAGLER ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33135-1638
Country	:	US
Telephone Number	:	305-643-6565
Fax Number	:	305-643-9454

Provider Business Practice Location Address
First Line	:	2167 W FLAGLER ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33135-1638
Country	:	US
Telephone Number	:	305-643-6565
Fax Number	:	305-643-9454

Authorized Official
Title or Position	:	PRESIDENT
Name	:	ROMILIO N LORITES
Credential	:
Telephone Number	:	305-643-6565

Provider Enumeration Date	:	05/16/2007
Last Update Date	:	08/22/2020

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