Illumina Medical Group Specialty, Llc

LBN: Illumina Medical Group Specialty, Llc
Illumina Medical Group Specialty, Llc is an health care organization with primary practice located at 1914 Nw 84Th Ave , Doral FL 33126. The organization recently has 4 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Ambulatory Health Care Facilities / Clinic/Center, Ambulatory Health Care Facilities / Multi-Specialty, Ambulatory Health Care Facilities / Medical Specialty. Ambulatory Health Care Facilities / Clinic/Center is the primary health care specialty. Illumina Medical Group Specialty, Llc can be contacted via phone (305) 254-8900, or through Mongeotti, Angel Andres via phone (305) 254-8900.

Contact Information

Primary practice address
1914 Nw 84Th Ave Doral FL 33126
Phone: (305) 254-8900
Fax: (305) 254-8902
Website:
Map and Directions
Authorized official contact:
Name: Mongeotti, Angel Andres
Phone: (305) 254-8900

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X
Ambulatory Health Care Facilities / Clinic/Center 261Q00000X
Ambulatory Health Care Facilities / Multi-Specialty 261QM1300X
Ambulatory Health Care Facilities / Medical Specialty 261QM2500X

Profile Details

NPI number 1437667078
LBN Legal business name Illumina Medical Group Specialty, Llc
DBA Doing business as
Authorized official Mongeotti, Angel Andres
Entity Organization
Organization subpart 1 No
Enumeration date Jan 17th, 2018
Last updated Jul 27th, 2018 - about 8 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1437667078 NPPES
Florida Other L17000260851 STATE DOCUMENT NUMBER

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