Provider Demographics
NPI:1790023521
Name:O S FLORIDA MEDICAL GROUP INC
Entity Type:Organization
Organization Name:O S FLORIDA MEDICAL GROUP INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:YURELIS
Authorized Official - Middle Name:
Authorized Official - Last Name:VALERON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-218-6980
Mailing Address - Street 1:7175 SW 8TH ST
Mailing Address - Street 2:SUITE 208
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33144-4676
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7175 SW 8TH ST
Practice Address - Street 2:SUITE 208
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33144-4676
Practice Address - Country:US
Practice Address - Phone:786-218-6980
Practice Address - Fax:305-603-8300
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-29
Last Update Date:2013-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care