Provider Demographics
NPI:1770001570
Name:ONYX MEDICAL GROUP INC
Entity Type:Organization
Organization Name:ONYX MEDICAL GROUP INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ORTELIO
Authorized Official - Middle Name:
Authorized Official - Last Name:RODRIGUEZ TORRES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-979-6178
Mailing Address - Street 1:1313 NW 36TH ST STE 100
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33142-5581
Mailing Address - Country:US
Mailing Address - Phone:305-954-5626
Mailing Address - Fax:305-964-5684
Practice Address - Street 1:1313 NW 36TH ST STE 100
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33142-5581
Practice Address - Country:US
Practice Address - Phone:305-954-5626
Practice Address - Fax:305-964-5684
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-01
Last Update Date:2022-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
No225XP0019XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPhysical RehabilitationGroup - Single Specialty
No261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
No261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder DiagnosticGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL024437500Medicaid