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Organization

ENT GROUP, LLC

Active
Parent organization
ENT GROUP, LLC
Organization subpart
Yes

Provider details

NPI number
Legal business name
ENT GROUP, LLC
Authorized official
OCTAVIO DE JESUS CARRENO (MANAGER)
(305) 859-0569
Entity
Organization

Contact information

Practice address
7190 SW 87TH AVE STE 403, MIAMI, FL 33173-2512
(305) 456-0772
Mailing address
2400 SW 69TH AVE, MIAMI, FL 33155-2919
(305) 859-0569
(305) 859-0569

Taxonomy

Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
207YX0007X
Plastic Surgery within the Head & Neck (Otolaryngology) Physician
Primary

Other

Enumeration date
10/24/2023
Last updated
10/24/2023
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