# OAKS MEDICAL GROUP LLC

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

## Provider details

- **NPI number:** 1932657921
- **Authorized official:** ROBERTO CUCURULLO PA (MEMBER)
- **Authorized official phone:** (305) 822-1243

## Contact information

- **Practice address:** 7761 NW 146TH ST, MIAMI LAKES, FL 33016-1559
- **Practice address phone:** (305) 822-1243
- **Practice address fax:** (305) 822-4260
- **Mailing address:** 7761 NW 146TH ST, MIAMI LAKES, FL 33016-1559
- **Mailing address phone:** (305) 822-1243
- **Mailing address fax:** (305) 822-4260

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | ME84810 | FL | Yes |
| 363AM0700X | Medical Physician Assistant | PA 9100128 | FL | — |

## Other

- **Enumeration date:** 09/19/2016
- **Last updated:** 09/19/2016