MEDICARE: SOUTH FLORIDA MEDICAL GROUP

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	261QP2300X	Primary Care Clinic/Center

General Provider Information

NPI Number	:	1770676561
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOUTH FLORIDA MEDICAL GROUP

Provider Business Mailing Address
First Line	:	2695 S LE JEUNE RD
Second Line	:	SUITE #300
City	:	CORAL GABLES
State	:	FL
Zip	:	33134-5839
Country	:	US
Telephone Number	:	305-446-0330
Fax Number	:	305-446-2841

Provider Business Practice Location Address
First Line	:	2695 S LE JEUNE RD
Second Line	:	SUITE #300
City	:	CORAL GABLES
State	:	FL
Zip	:	33134-5839
Country	:	US
Telephone Number	:	305-446-0330
Fax Number	:	305-446-2841

Authorized Official
Title or Position	:	OWNER
Name	:	DR. GERARDO FRANCISCO SANTOS
Credential	:	M.D.
Telephone Number	:	305-446-0330

Provider Enumeration Date	:	10/02/2006
Last Update Date	:	08/22/2020

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Directions to “SOUTH FLORIDA MEDICAL GROUP ” Practice Location

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