SUPRA MEDICAL GROUP II LLC NPI 1205592656

NPI Information

SUPRA MEDICAL GROUP II, LLC is a general practice in Miami, FL. The provider is a physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee SUPRA MEDICAL GROUP II, LLC NPI is 1205592656. The provider is registered as an organization entity type.

The provider's business location address is:

10300 SW 72ND ST STE 387
MIAMI, FL
ZIP 33173-020
Phone: (305) 200-5210
Fax: (305) 200-5780

The provider's authorized official is Kleydson Da Silva .
The authorized official title is Ceo and has the following contact phone number (305) 200-5210.

The CLIA number assigned to this NPI record is 10D2258510 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/10/2021 and was last updated on 11/10/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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