EASTERN MEDICAL GROUP CORP NPI 1093241465

NPI Information

  • NPI: 1093241465
  • Provider Name: EASTERN MEDICAL GROUP CORP
  • Classification: General Practice - 208D00000X
  • Entity Type: Organization
  • CLIA Number: 10D2174327
  • Address: 8900 CORAL WAY
    SUITE 202
    MIAMI, FL
    ZIP 33165
  • Phone: (305) 392-0765

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NPI Details

EASTERN MEDICAL GROUP CORP 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 EASTERN MEDICAL GROUP CORP NPI is 1093241465. The provider is registered as an organization entity type.

The provider's business location address is:

8900 CORAL WAY
SUITE 202
MIAMI, FL
ZIP 33165-075
Phone: (305) 392-0765

The provider's authorized official is Christian Dominguez .
The authorized official title is President and has the following contact phone number (305) 392-0765.

The CLIA number assigned to this NPI record is 10D2174327 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/4/2017 and was last updated on 9/11/2023.

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:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261Q00000XClinic/CenterHCC11007FLORIDANo
2208D00000XGeneral PracticeYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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