Organization
INDEPENDENT MEDICAL GROUP, LLC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SONIA N TORRES (CLINICAL OPERATIONS MANAGER)
(407) 505-6435
Entity
Organization
Contact information
Practice address
3880 COCONUT CREEK PKWY STE 100, COCONUT CREEK, FL 33066-1643
(407) 312-7392
Mailing address
5701 NW 88TH AVE STE 390, TAMARAC, FL 33321-4451
(407) 860-0283
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
—
—
261QH0100X
Health Service Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
850496596
HRSA
FL
Enumeration date
01/27/2022
Last updated
09/28/2023
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