| Southern Medical Group | |
|
1111 12th St Suite210 Key West FL 33040-4088 | |
| (305) 296-2414 | |
| Not Available |
| Full Name | Southern Medical Group |
|---|---|
| Speciality | Internal Medicine |
| Location | 1111 12th St, Key West, Florida |
| Authorized Official Name and Position | Lisa Lacova (BILLING MANAGER) |
| Authorized Official Contact | 9544261186 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Southern Medical Group 1111 12th St Suite210 Key West FL 33040-4088 Ph: (305) 296-2414 | Southern Medical Group 1111 12th St Suite210 Key West FL 33040-4088 Ph: (305) 296-2414 |
| NPI Number | 1477605285 |
|---|---|
| Provider Enumeration Date | 01/18/2007 |
| Last Update Date | 02/11/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477605285 | NPI | - | NPPES |
| 067849000 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
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