Provider Demographics
NPI:1447405741
Name:INFINITY MEDICAL GROUP, INC
Entity Type:Organization
Organization Name:INFINITY MEDICAL GROUP, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:
Authorized Official - Last Name:DIAZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-398-7832
Mailing Address - Street 1:8927 HYPOLUXO RD
Mailing Address - Street 2:A 4 # 226
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33467-5249
Mailing Address - Country:US
Mailing Address - Phone:561-398-7832
Mailing Address - Fax:
Practice Address - Street 1:8927 HYPOLUXO RD
Practice Address - Street 2:A 4 # 226
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33467-5249
Practice Address - Country:US
Practice Address - Phone:561-398-7832
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-01
Last Update Date:2008-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies