| Supra Medical Group Ii, Llc | |
|
10300 Sw 72nd St Ste 387 Miami FL 33173-3020 | |
| (305) 200-5210 | |
| (305) 200-5780 |
| Full Name | Supra Medical Group Ii, Llc |
|---|---|
| Speciality | General Practice |
| Location | 10300 Sw 72nd St Ste 387, Miami, Florida |
| Authorized Official Name and Position | Kleydson Da Silva (CEO) |
| Authorized Official Contact | 3052005210 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Supra Medical Group Ii, Llc 10300 Sw 72nd St Ste 387 Miami FL 33173-3020 Ph: (305) 200-5210 | Supra Medical Group Ii, Llc 10300 Sw 72nd St Ste 387 Miami FL 33173-3020 Ph: (305) 200-5210 |
| NPI Number | 1205592656 |
|---|---|
| Provider Enumeration Date | 11/10/2021 |
| Last Update Date | 11/10/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205592656 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
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