Provider Demographics
NPI:1922443407
Name:SENIOR MEDICAL CARE GROUP LLC
Entity Type:Organization
Organization Name:SENIOR MEDICAL CARE GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MNG
Authorized Official - Prefix:
Authorized Official - First Name:ALFREDO
Authorized Official - Middle Name:J
Authorized Official - Last Name:MELGAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-401-0441
Mailing Address - Street 1:11760 SW 40TH ST
Mailing Address - Street 2:SUITE 616
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33175-3582
Mailing Address - Country:US
Mailing Address - Phone:305-401-0441
Mailing Address - Fax:954-432-5060
Practice Address - Street 1:11760 SW 40TH ST
Practice Address - Street 2:SUITE 616
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33175-3582
Practice Address - Country:US
Practice Address - Phone:305-401-0441
Practice Address - Fax:954-432-5060
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-09
Last Update Date:2013-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME1027962207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty