Organization
MDLIVE MEDICAL GROUP IL LLC
Active
Parent organization
MDLIVE MEDICAL GROUP IL LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
MDLIVE MEDICAL GROUP IL LLC
Authorized official
MERRY SCHUMACHER (SR. DIRECTOR PROVIDER SERVICES)
(800) 400-6354
Entity
Organization
Contact information
Practice address
3350 SW 148TH AVE STE 300, MIRAMAR, FL 33027-3259
(800) 400-6354
Mailing address
3350 SW 148TH AVE STE 300, MIRAMAR, FL 33027-3259
(800) 400-6354
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
10/28/2022
Last updated
10/28/2022
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