Provider Demographics
NPI:1801481882
Name:MRM MEDICAL GROUP
Entity type:Organization
Organization Name:MRM MEDICAL GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:RANDY
Authorized Official - Middle Name:
Authorized Official - Last Name:HERFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-704-6781
Mailing Address - Street 1:4060 ARTESA DR
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33436-2628
Mailing Address - Country:US
Mailing Address - Phone:561-704-6781
Mailing Address - Fax:
Practice Address - Street 1:1640 POWERS FERRY RD BUILDING 15 SUITE 200
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30067-2067
Practice Address - Country:US
Practice Address - Phone:561-704-6781
Practice Address - Fax:561-209-0868
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-02
Last Update Date:2021-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty