Organization
EM MSO GROUP CORP.
Active
Other names
Eastern Medical MSO
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAVIER MENENDEZ (COO)
(305) 298-3272
Entity
Organization
Contact information
Practice address
5835 BLUE LAGOON DR STE 300, MIAMI, FL 33126-6046
(305) 298-3272
Mailing address
5835 BLUE LAGOON DR STE 300, MIAMI, FL 33126-6046
(305) 298-3272
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
—
—
302R00000X
Health Maintenance Organization
Primary
—
—
305R00000X
Preferred Provider Organization
—
—
Other
Enumeration date
01/18/2022
Last updated
01/19/2022
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