Provider Demographics
NPI:1275978140
Name:WESTERN MEDICAL GROUP INC
Entity Type:Organization
Organization Name:WESTERN MEDICAL GROUP INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GUINA
Authorized Official - Middle Name:
Authorized Official - Last Name:SENAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-409-2261
Mailing Address - Street 1:7821 CORAL WAY STE 130
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33155-6542
Mailing Address - Country:US
Mailing Address - Phone:786-409-2261
Mailing Address - Fax:786-409-2267
Practice Address - Street 1:7821 CORAL WAY STE 130
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33155-6542
Practice Address - Country:US
Practice Address - Phone:786-409-2261
Practice Address - Fax:786-409-2267
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-06
Last Update Date:2013-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHCC10565261QR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation