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Organization

MIAMI MED GROUP INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DILIO BRAVO APRN (PRESIDENT/OWNER)
(786) 206-8521
Entity
Organization

Contact information

Practice address
12700 SW 122ND AVE, SUITE 105, MIAMI, FL 33186-5271
(786) 206-8521
(786) 741-2636
Mailing address
12700 SW 122ND AVE, SUITE 105, MIAMI, FL 33186-5271
(786) 206-8521
(786) 741-2636

Taxonomy

Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
261QP2300X
Primary Care Clinic/Center
261QR1100X
Research Clinic/Center

Other

Enumeration date
08/06/2021
Last updated
11/02/2023
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