| Southern Medical Services Group,inc. | |
|
3342 Ne 34th St Fort Lauderdale FL 33308-6906 | |
| (954) 583-7267 | |
| (954) 583-0535 |
| Full Name | Southern Medical Services Group,inc. |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 3342 Ne 34th St, Fort Lauderdale, Florida |
| Authorized Official Name and Position | Priti M Shah (OFFICE MANAGER) |
| Authorized Official Contact | 9545837267 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Southern Medical Services Group,inc. 3342 Ne 34th St Fort Lauderdale FL 33308-6906 Ph: (954) 583-7267 | Southern Medical Services Group,inc. 3342 Ne 34th St Fort Lauderdale FL 33308-6906 Ph: (954) 583-7267 |
| NPI Number | 1881892073 |
|---|---|
| Provider Enumeration Date | 07/10/2007 |
| Last Update Date | 10/09/2014 |
| Medicare PECOS PAC ID | 0941495436 |
|---|---|
| Medicare Enrollment ID | O20101110000358 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881892073 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0805X | Psychiatry & Neurology - Geriatric Psychiatry | ME36479 (Florida) | Primary |
| Provider Name | Shobha Gupta |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1306883038 PECOS PAC ID: 9537165667 Enrollment ID: I20061013000176 |
| Provider Name | Muthuramalingam Rammohan |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1649457052 PECOS PAC ID: 8224114905 Enrollment ID: I20141208000705 |
| Provider Name | Marie S Joseph |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760911366 PECOS PAC ID: 9436402039 Enrollment ID: I20181029002920 |
| Provider Name | Smitha Ajesh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356940217 PECOS PAC ID: 4587076898 Enrollment ID: I20201210000821 |
| Provider Name | Biju Antony |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912582008 PECOS PAC ID: 6002209699 Enrollment ID: I20220202002621 |
| Provider Name | Crystol Vassell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558137265 PECOS PAC ID: 9234664699 Enrollment ID: I20241121001990 |
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