| Bermudez Medical Group, Llc. | |
|
2601 Davie Blvd Ste B Fort Lauderdale FL 33312-3029 | |
| (305) 300-5501 | |
| (305) 383-7408 |
| Full Name | Bermudez Medical Group, Llc. |
|---|---|
| Speciality | Family Medicine |
| Location | 2601 Davie Blvd Ste B, Fort Lauderdale, Florida |
| Authorized Official Name and Position | Lidia Rosa Bermudez (M.D.) |
| Authorized Official Contact | 3053005501 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bermudez Medical Group, Llc. 2601 Davie Blvd Ste B Fort Lauderdale FL 33312-3029 Ph: (305) 300-5501 | Bermudez Medical Group, Llc. 2601 Davie Blvd Ste B Fort Lauderdale FL 33312-3029 Ph: (305) 300-5501 |
| NPI Number | 1700396637 |
|---|---|
| Provider Enumeration Date | 10/05/2017 |
| Last Update Date | 10/05/2017 |
| Medicare PECOS PAC ID | 3577824788 |
|---|---|
| Medicare Enrollment ID | O20180305001644 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700396637 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QA0505X | Family Medicine - Adult Medicine | (* (Not Available)) | Primary |
| Provider Name | Lidia R Bermudez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1730250663 PECOS PAC ID: 1850338443 Enrollment ID: I20050415000204 |
| Provider Name | Nedelis C Buela |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265953756 PECOS PAC ID: 7315287604 Enrollment ID: I20190325000245 |
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