Organization
MDLIVE MEDICAL GROUP DE PA
Active
Other names
MDLIVE MEDICAL GROUP
Organization subpart
No
Provider details
NPI number
Authorized official
SUE-ANN ADRIANS (GOVERNMENT PROGRAMS PM)
(945) 275-1345
Entity
Organization
Contact information
Practice address
900 COTTAGE GROVE RD, BLOOMFIELD, CT 06002-2920
(800) 400-6354
Mailing address
3350 SW 148TH AVE STE 300, MIRAMAR, FL 33027-3259
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
104100000X
Social Worker
—
—
207N00000X
Dermatology Physician
—
—
207P00000X
Emergency Medicine Physician
—
—
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
207RS0010X
Sports Medicine (Internal Medicine) Physician
—
—
208000000X
Pediatrics Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
335824
—
AZ
Enumeration date
11/10/2015
Last updated
02/25/2026
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