Provider Demographics
NPI:1265834204
Name:SOUTH FLORIDA PHYSICIANS GROUP LLC
Entity Type:Organization
Organization Name:SOUTH FLORIDA PHYSICIANS GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:DR
Authorized Official - First Name:JUAN
Authorized Official - Middle Name:ANTONIO
Authorized Official - Last Name:QUINTANA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-335-9480
Mailing Address - Street 1:299 ALHAMBRA CIRCLE
Mailing Address - Street 2:SUITE 401
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-5106
Mailing Address - Country:US
Mailing Address - Phone:305-335-9480
Mailing Address - Fax:305-754-4947
Practice Address - Street 1:299 ALHAMBRA CIRCLE
Practice Address - Street 2:SUITE 401
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-5106
Practice Address - Country:US
Practice Address - Phone:305-335-9480
Practice Address - Fax:305-754-4947
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-22
Last Update Date:2014-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty