# MIAMI MED GROUP INC

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

## Provider details

- **NPI number:** 1942974555
- **Authorized official:** DILIO BRAVO APRN (PRESIDENT/OWNER)
- **Authorized official phone:** (786) 206-8521

## Contact information

- **Practice address:** 12700 SW 122ND AVE, SUITE 105, MIAMI, FL 33186-5271
- **Practice address phone:** (786) 206-8521
- **Practice address fax:** (786) 741-2636
- **Mailing address:** 12700 SW 122ND AVE, SUITE 105, MIAMI, FL 33186-5271
- **Mailing address phone:** (786) 206-8521
- **Mailing address fax:** (786) 741-2636

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | — | — | Yes |
| 261QP2300X | Primary Care Clinic/Center | — | — | — |
| 261QR1100X | Research Clinic/Center | — | — | — |

## Other

- **Enumeration date:** 08/06/2021
- **Last updated:** 11/02/2023