Organization
PEDIATRIC MEDICINE ASSOCIATES GROUP INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JORGE A DE DIEGO (MD)
(305) 477-7111
Entity
Organization
Contact information
Practice address
10820 NW 58TH ST, DORAL, FL 33178-2854
(305) 477-7111
(305) 594-3126
Mailing address
10820 NW 58TH ST, DORAL, FL 33178-2854
(305) 477-7111
(305) 594-3126
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
ME48450
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
106861000
—
FL
05
—
1811026354
—
FL
Enumeration date
03/02/2007
Last updated
11/16/2022
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