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Organization
POMPANO MEDICAL SPECIALTY GROUP
Active
Organization
POMPANO MEDICAL SPECIALTY GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MAYRA FUENTES (CEO)
(561) 932-8155
Entity
Organization
Contact information
Practice address
2700 W ATLANTIC BLVD STE 214, POMPANO BEACH, FL 33069-5727
(561) 932-8155
Mailing address
2700 W ATLANTIC BLVD STE 214, POMPANO BEACH, FL 33069-5727
(561) 932-8155
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
—
NULL
207W00000X
Ophthalmology Physician
Primary
—
—
Other
Enumeration date
01/24/2018
Last updated
01/24/2018
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