INDEPENDENT MEDICAL GROUP LLC. NPI 1790376945

NPI Information

NPI: 1790376945
Provider Name: INDEPENDENT MEDICAL GROUP, LLC.
Classification: Clinic/Center - 261QH0100X
Entity Type: Organization

Specialization: Health Service

CLIA Number: 10D2211416

Address:
28420 BONITA CROSSINGS BLVD SUITE 130
BONITA SPRINGS, FL
ZIP 34135
Phone: (407) 314-7492
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INDEPENDENT MEDICAL GROUP, LLC. is a health service clinic center in Bonita Springs, FL. INDEPENDENT MEDICAL GROUP, LLC. NPI is 1790376945. The provider is registered as an organization entity type.

The provider's business location address is:

28420 BONITA CROSSINGS BLVD SUITE 130
BONITA SPRINGS, FL
ZIP 34135
Phone: (407) 314-7492
Fax: (833) 258-4230

The provider's authorized official is Sonia N Torres .
The authorized official title is Clinical Operations Manager and has the following contact phone number (407) 505-6435.

The CLIA number assigned to this NPI record is 10D2211416 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/31/2021 and was last updated on 1/31/2021.

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:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QH0100X	Clinic/Center	Health Service			Yes

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: 11/14/2023

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