Organization
MDLIVE MEDICAL GROUP DE PA
Active
Organization
MDLIVE MEDICAL GROUP DE PA
Active
Parent organization
MDLIVE MEDICAL GROUP DE PA
Other names
MDLIVE Medical Group
Organization subpart
Yes
Provider details
NPI number
Legal business name
MDLIVE MEDICAL GROUP DE PA
Authorized official
SUE-ANN ADRIANS (GOVERNMENT PROGRAMS PM)
(945) 275-1345
Entity
Organization
Contact information
Practice address
900 COTTAGE GROVE RD, BLOOMFIELD, CT 06002-2920
(800) 400-6354
Mailing address
3350 SW 148TH AVE STE 300, MIRAMAR, FL 33027-3259
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
103T00000X
Psychologist
—
—
104100000X
Social Worker
—
—
106H00000X
Marriage & Family Therapist
—
—
2084P0800X
Psychiatry Physician
Primary
—
—
Other
Enumeration date
05/25/2022
Last updated
02/25/2026
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