Organization
MICHAEL MEDICAL GROUP INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL FORMISANO (PRESIDENT)
(305) 381-5962
Entity
Organization
Contact information
Practice address
4800 W FLAGLER ST STE 110, CORAL GABLES, FL 33134-1400
(305) 381-5962
Mailing address
4800 W FLAGLER ST STE 110, CORAL GABLES, FL 33134-1400
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Enumeration date
05/07/2013
Last updated
05/07/2013
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