| Miami Med Group Inc | |
|
12700 Sw 122nd Ave Suite 105 Miami FL 33186-5271 | |
| (786) 206-8521 | |
| (786) 741-2636 |
| Full Name | Miami Med Group Inc |
|---|---|
| Speciality | General Practice |
| Location | 12700 Sw 122nd Ave, Miami, Florida |
| Authorized Official Name and Position | Dilio Bravo (PRESIDENT/OWNER) |
| Authorized Official Contact | 7862068521 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Miami Med Group Inc 12700 Sw 122nd Ave Suite 105 Miami FL 33186-5271 Ph: (786) 206-8521 | Miami Med Group Inc 12700 Sw 122nd Ave Suite 105 Miami FL 33186-5271 Ph: (786) 206-8521 |
| NPI Number | 1942974555 |
|---|---|
| Provider Enumeration Date | 08/06/2021 |
| Last Update Date | 11/02/2023 |
| Medicare PECOS PAC ID | 5193121408 |
|---|---|
| Medicare Enrollment ID | O20210913002139 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942974555 | NPI | - | NPPES |
| Provider Name | Dayuri Gallardo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417414046 PECOS PAC ID: 0244571438 Enrollment ID: I20190613000673 |
| Provider Name | Dilio Bravo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093348716 PECOS PAC ID: 3476728460 Enrollment ID: I20201113000390 |
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