Organization
NEW WAVE MEDICAL GROUP PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DALIA ELIZALDE (MANAGER)
(844) 327-2199
Entity
Organization
Contact information
Practice address
9018 60TH AVE E, BRADENTON, FL 34202-9642
(844) 327-2199
Mailing address
9018 60TH AVE E, BRADENTON, FL 34202-9642
(844) 327-2199
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
03/16/2022
Last updated
01/27/2023
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