# FLORIDA MEDICAL CENTER GROUP, INC.

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

## Provider details

- **NPI number:** 1396002929
- **Authorized official:** MRS. MADELAINE SOUTO (CEO)
- **Authorized official phone:** (786) 378-8200

## Contact information

- **Practice address:** 1501 NW 36 ST, MIAMI, FL 33142-9998
- **Practice address phone:** (786) 378-8200
- **Practice address fax:** (305) 907-5299
- **Mailing address:** 1501 NW 36TH ST, MIAMI, FL 33142-5559
- **Mailing address phone:** (786) 378-8200
- **Mailing address fax:** (305) 907-5299

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1744R1102X | Research Study Specialist | — | NULL | — |
| 1744R1102X | Research Study Specialist | — | — | — |
| 207Q00000X | Family Medicine Physician | — | NULL | — |
| 207Q00000X | Family Medicine Physician | — | — | — |
| 207QA0000X | Adolescent Medicine (Family Medicine) Physician | — | NULL | Yes |
| 207QA0000X | Adolescent Medicine (Family Medicine) Physician | — | — | Yes |
| 207QA0505X | Adult Medicine Physician | — | NULL | — |
| 207QA0505X | Adult Medicine Physician | — | — | — |
| 207QG0300X | Geriatric Medicine (Family Medicine) Physician | — | NULL | — |
| 207QG0300X | Geriatric Medicine (Family Medicine) Physician | — | — | — |

## Other

- **Enumeration date:** 04/20/2012
- **Last updated:** 12/31/2018