# MANAGED HEALTHCARE MEDICAL GROUP LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1255032025
- **Authorized official:** LUCINDA BLUNT (CEO)
- **Authorized official phone:** (754) 224-9333

## Contact information

- **Practice address:** 150 S PINE ISLAND RD STE 300, PLANTATION, FL 33324-2665
- **Practice address phone:** (754) 224-9333
- **Practice address fax:** (954) 337-8265
- **Mailing address:** 150 S PINE ISLAND RD STE 300, PLANTATION, FL 33324-2665
- **Mailing address phone:** (754) 224-9333
- **Mailing address fax:** (954) 337-8265

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 302F00000X | Exclusive Provider Organization | — | NULL | Yes |

## Other

- **Enumeration date:** 03/16/2023
- **Last updated:** 03/16/2023