MEDICARE: ESSENTIAL 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	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1861005050
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ESSENTIAL MEDICAL GROUP LLC

Provider Business Mailing Address
First Line	:	1840 CORAL WAY STE 209
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33145-2748
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1840 CORAL WAY STE 209
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33145-2748
Country	:	US
Telephone Number	:	877-787-7868
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	ALEX GARCIA
Credential	:
Telephone Number	:	877-787-7868

Provider Enumeration Date	:	08/26/2020
Last Update Date	:	08/26/2020

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Directions to “ESSENTIAL MEDICAL GROUP LLC ” Practice Location

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