Provider Demographics
NPI:1093225641
Name:PHYSICIANS PARTNERS GROUP OF FL, LLC.
Entity Type:Organization
Organization Name:PHYSICIANS PARTNERS GROUP OF FL, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JOEL
Authorized Official - Middle Name:
Authorized Official - Last Name:LAGO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-332-3222
Mailing Address - Street 1:5801 NW 151 ST STE 105
Mailing Address - Street 2:
Mailing Address - City:MIAMI LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33014
Mailing Address - Country:US
Mailing Address - Phone:786-332-3222
Mailing Address - Fax:786-332-3230
Practice Address - Street 1:5801 NW 151 ST. STE 105
Practice Address - Street 2:
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33014
Practice Address - Country:US
Practice Address - Phone:786-332-3222
Practice Address - Fax:786-332-3230
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-10
Last Update Date:2017-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care