Loyal Medical Group Inc | |
8395 W Oakland Park Blvd Ste C Sunrise FL 33351-7346 | |
(954) 335-6925 | |
(954) 400-3550 |
Full Name | Loyal Medical Group Inc |
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Speciality | Family Medicine |
Location | 8395 W Oakland Park Blvd Ste C, Sunrise, Florida |
Authorized Official Name and Position | Ilit Hanna Osher (PRESIDENT) |
Authorized Official Contact | 9543356925 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Loyal Medical Group Inc 8395 W Oakland Park Blvd Ste C Sunrise FL 33351-7346 Ph: (954) 335-6925 | Loyal Medical Group Inc 8395 W Oakland Park Blvd Ste C Sunrise FL 33351-7346 Ph: (954) 335-6925 |
NPI Number | 1922787688 |
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Provider Enumeration Date | 07/11/2023 |
Last Update Date | 05/16/2024 |
Medicare PECOS PAC ID | 4880030733 |
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Medicare Enrollment ID | O20240313003504 |
Identifier | Type | State | Issuer |
---|---|---|---|
1922787688 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Secondary |
Provider Name | Todd Jacobs |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1669452264 PECOS PAC ID: 2668578329 Enrollment ID: I20070426000459 |
Provider Name | Barbara Joseph- Garcia |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1578005765 PECOS PAC ID: 9537418223 Enrollment ID: I20180813003302 |
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