Provider Demographics
NPI:1669850020
Name:MEDGROUP MEDICAL CENTER
Entity Type:Organization
Organization Name:MEDGROUP MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:DR
Authorized Official - First Name:SANTIAGO
Authorized Official - Middle Name:
Authorized Official - Last Name:VERA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-250-5600
Mailing Address - Street 1:5200 SW 8TH ST STE 150
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-2300
Mailing Address - Country:US
Mailing Address - Phone:305-250-5600
Mailing Address - Fax:
Practice Address - Street 1:5200 SW 8TH ST STE 150
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-2300
Practice Address - Country:US
Practice Address - Phone:305-250-5600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-18
Last Update Date:2015-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332900000XSuppliersNon-Pharmacy Dispensing Site