Organization
ETERNITY MEDICAL GROUP CORP
Active
Organization
ETERNITY MEDICAL GROUP CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LUIS AGUILAR (OWNER/PRESIDENT)
(786) 332-3136
Entity
Organization
Contact information
Practice address
900 SW 8TH ST STE C1, MIAMI, FL 33130-3756
(786) 332-3136
(305) 726-0013
Mailing address
900 SW 8TH ST STE C1, MIAMI, FL 33130-3756
(786) 332-3136
(305) 726-0013
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
261Q00000X
Clinic/Center
Primary
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
261QP2300X
Primary Care Clinic/Center
—
—
291U00000X
Clinical Medical Laboratory
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
108835400
—
FL
01
—
13052
HEALTH CARE CLINIC STANDARD LICENSE
FL
Enumeration date
11/13/2020
Last updated
08/14/2025
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