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Organization
SUPRA MEDICAL GROUP II, LLC
Active
Organization
SUPRA MEDICAL GROUP II, LLC
Active
Parent organization
SUPRA MEDICAL GROUP II, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
SUPRA MEDICAL GROUP II, LLC
Authorized official
KLEYDSON DA SILVA (CEO)
(305) 200-5210
Entity
Organization
Contact information
Practice address
10300 SW 72ND ST STE 387, MIAMI, FL 33173-3020
(305) 200-5210
(305) 200-5780
Mailing address
10300 SW 72ND ST STE 387, MIAMI, FL 33173-3020
(305) 200-5210
(305) 200-5780
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
251S00000X
Community/Behavioral Health Agency
—
—
Other
Enumeration date
11/10/2021
Last updated
11/10/2021
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