MEDICARE: MANAGED CARE GROUP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	225100000X	Physical Therapist
2	225700000X	Massage Therapist
3	225X00000X	Occupational Therapist
4	363L00000X	Nurse Practitioner
5	363A00000X	Physician Assistant

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1962651125
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MANAGED CARE GROUP

Provider Business Mailing Address
First Line	:	3109 GRAND AVE
Second Line	:	277
City	:	MIAMI
State	:	FL
Zip	:	33133-5103
Country	:	US
Telephone Number	:	800-316-3183
Fax Number	:	866-810-9894

Provider Business Practice Location Address
First Line	:	3109 GRAND AVE
Second Line	:	277
City	:	MIAMI
State	:	FL
Zip	:	33133-5103
Country	:	US
Telephone Number	:	800-316-3183
Fax Number	:	866-810-9894

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. JAYSON BAILEY
Credential	:	MBA
Telephone Number	:	305-439-3783

Provider Enumeration Date	:	09/12/2008
Last Update Date	:	09/12/2008

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Directions to “MANAGED CARE GROUP ” Practice Location

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