# ALS MEDICAL GROUP MIAMI GARDENS LLC

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

## Provider details

- **NPI number:** 1427789601
- **Authorized official:** MARICELA NICOLAS (OWNER)
- **Authorized official phone:** (305) 303-9154

## Contact information

- **Practice address:** 4888 NW 183RD ST STE 112, MIAMI GARDENS, FL 33055-2940
- **Practice address phone:** (305) 317-3948
- **Practice address fax:** (305) 549-5314
- **Mailing address:** 4888 NW 183RD ST STE 112, MIAMI GARDENS, FL 33055-2940
- **Mailing address phone:** (305) 317-3948
- **Mailing address fax:** (305) 549-5314

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | — | — | Yes |

## Other

- **Enumeration date:** 06/20/2022
- **Last updated:** 10/24/2022