| Illumina Medical Group Jv, Llc | |
|
1914 Nw 84th Ave Doral FL 33126 | |
| (305) 254-8900 | |
| Not Available |
| Full Name | Illumina Medical Group Jv, Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 1914 Nw 84th Ave, Doral, Florida |
| Authorized Official Name and Position | Angel Mongeotti (EXECUTIVE DIRECTOR OF FINANCE) |
| Authorized Official Contact | 3052548900 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Illumina Medical Group Jv, Llc 1914 Nw 84th Ave Doral FL 33126-1030 Ph: (305) 254-8900 | Illumina Medical Group Jv, Llc 1914 Nw 84th Ave Doral FL 33126 Ph: (305) 254-8900 |
| NPI Number | 1699260950 |
|---|---|
| Provider Enumeration Date | 06/28/2018 |
| Last Update Date | 07/27/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699260950 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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