MEDICARE: MEDICAL GENERAL ASSISTANT 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	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1942254495
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MEDICAL GENERAL ASSISTANT INC

Provider Business Mailing Address
First Line	:	7911 NW 72ND AVE
Second Line	:	SUITE 213 A&B
City	:	MEDLEY
State	:	FL
Zip	:	33166-2227
Country	:	US
Telephone Number	:	305-883-7511
Fax Number	:

Provider Business Practice Location Address
First Line	:	7911 NW 72ND AVE
Second Line	:	SUITE 213 A&B
City	:	MEDLEY
State	:	FL
Zip	:	33166-2227
Country	:	US
Telephone Number	:	305-883-7511
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	YAMILET CARDENAS
Credential	:
Telephone Number	:	305-883-7511

Provider Enumeration Date	:	05/20/2006
Last Update Date	:	08/22/2020

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