Provider Demographics
NPI:1609657808
Name:M&V MEDICAL GROUP PA
Entity Type:Organization
Organization Name:M&V MEDICAL GROUP PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MIRA
Authorized Official - Middle Name:
Authorized Official - Last Name:ZEITLIN
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:954-608-4586
Mailing Address - Street 1:2500 E HALLANDALE BEACH BLVD STE 609
Mailing Address - Street 2:
Mailing Address - City:HALLANDALE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33009-4839
Mailing Address - Country:US
Mailing Address - Phone:954-333-8665
Mailing Address - Fax:
Practice Address - Street 1:2500 E HALLANDALE BEACH BLVD STE 609
Practice Address - Street 2:
Practice Address - City:HALLANDALE BEACH
Practice Address - State:FL
Practice Address - Zip Code:33009-4839
Practice Address - Country:US
Practice Address - Phone:954-333-8665
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-12
Last Update Date:2023-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty