# SOUTH FLORIDA MULTI-SPECIALTY MEDICAL GROUP LLC

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

## Provider details

- **NPI number:** 1629789417
- **Authorized official:** PETER H HANNA (CEO)
- **Authorized official phone:** (833) 735-3668

## Contact information

- **Practice address:** 1036 NW 1ST AVE, HOMESTEAD, FL 33030-4417
- **Practice address phone:** (833) 735-3668
- **Practice address fax:** (866) 897-7014
- **Mailing address:** 8950 SW 74TH CT STE 1408, MIAMI, FL 33156-3173
- **Mailing address phone:** (833) 735-3668
- **Mailing address fax:** (866) 897-7014

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | — | NULL | — |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | — | — | — |
| 261QM1300X | Multi-Specialty Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 12/12/2022
- **Last updated:** 12/13/2022