Provider Demographics
NPI:1821306564
Name:HEALTH MANAGEMENT MEDICAL GROUP, LLC
Entity Type:Organization
Organization Name:HEALTH MANAGEMENT MEDICAL GROUP, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:HIEN
Authorized Official - Middle Name:
Authorized Official - Last Name:LE
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:407-749-2222
Mailing Address - Street 1:7800 N UNIVERSITY DR
Mailing Address - Street 2:101-102
Mailing Address - City:TAMARAC
Mailing Address - State:FL
Mailing Address - Zip Code:33321-2128
Mailing Address - Country:US
Mailing Address - Phone:954-726-1662
Mailing Address - Fax:954-726-1678
Practice Address - Street 1:7800 N UNIVERSITY DR
Practice Address - Street 2:101-102
Practice Address - City:TAMARAC
Practice Address - State:FL
Practice Address - Zip Code:33321-2128
Practice Address - Country:US
Practice Address - Phone:954-726-1662
Practice Address - Fax:954-726-1678
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-15
Last Update Date:2010-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty