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NPI Code Detail

MEDICARE: SHALOM MEDICAL GROUP INC

MEDICARE: SHALOM MEDICAL GROUP 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
12084P0800XPsychiatry Physician

General Provider Information

NPI Number : 1851521447
Entity Type Code : Organization
Provider Name (Legal Business Name) : SHALOM MEDICAL GROUP INC
Provider Business Mailing Address
First Line : 5601 COLLINS AVE STE CU1
Second Line :
City : MIAMI BEACH
State : FL
Zip : 33140-2415
Country : US
Telephone Number : 305-993-5558
Fax Number : 305-993-5770
Provider Business Practice Location Address
First Line : 5601 COLLINS AVE STE CU1
Second Line :
City : MIAMI BEACH
State : FL
Zip : 33140-2415
Country : US
Telephone Number : 305-993-5558
Fax Number : 305-993-5770
Authorized Official
Title or Position : VICE PRESIDENT
Name : JUAN E DELGADO
Credential :
Telephone Number : 305-993-5558
Provider Enumeration Date : 07/17/2009
Last Update Date : 07/17/2009

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Directions to “SHALOM MEDICAL GROUP INC ” Practice Location

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