Organization
DIVERSIFIED MEDICAL GROUP, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GABRIEL A DELGADO (PRESIDENT)
(305) 662-8559
Entity
Organization
Contact information
Practice address
18619 SW 107TH AVE, CUTLER BAY, FL 33157-6728
(305) 662-8559
(305) 667-6280
Mailing address
18619 SW 107TH AVE, CUTLER BAY, FL 33157-6728
(305) 662-8559
(305) 667-6280
Taxonomy
Speciality
Code
Description
License number
State
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
847
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
025107100
—
FL
Enumeration date
11/29/2006
Last updated
03/30/2009
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