Provider Demographics
NPI:1407044076
Name:CNG PROFESSIONAL GROUP INC
Entity Type:Organization
Organization Name:CNG PROFESSIONAL GROUP INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/ OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NICOMEDES
Authorized Official - Middle Name:
Authorized Official - Last Name:MACHADO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-246-2378
Mailing Address - Street 1:9290 SW 72ND ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33173-3236
Mailing Address - Country:US
Mailing Address - Phone:305-273-9719
Mailing Address - Fax:305-273-9796
Practice Address - Street 1:9290 SW 72ND ST
Practice Address - Street 2:SUITE 101
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-3236
Practice Address - Country:US
Practice Address - Phone:305-273-9719
Practice Address - Fax:305-273-9796
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-09
Last Update Date:2007-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center