Diversified Medical Group, Inc

Primary specialty

Oxygen Equipment & Supplies (DME)Taxonomy code 332BX2000X

License

847 Issued in FL

Legal business name

DIVERSIFIED MEDICAL GROUP, INC

Practice address

18619 SW 107TH Ave
Cutler Bay, FL 33157-6728

Phone

(305) 662-8559

Fax

(305) 667-6280

NPI assigned

Nov 29, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Gabriel A Delgado

Title

President

Phone

(305) 662-8559

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1164758400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1238371200000",
    "number": "1033286034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18619 SW 107TH AVE",
            "city": "CUTLER BAY",
            "state": "FL",
            "postal_code": "331576728",
            "telephone_number": "305-662-8559",
            "fax_number": "305-667-6280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18619 SW 107TH AVE",
            "city": "CUTLER BAY",
            "state": "FL",
            "postal_code": "331576728",
            "telephone_number": "305-662-8559",
            "fax_number": "305-667-6280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVERSIFIED MEDICAL GROUP, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-29",
        "last_updated": "2009-03-30",
        "status": "A",
        "authorized_official_last_name": "DELGADO",
        "authorized_official_first_name": "GABRIEL",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "305-662-8559",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": "FL",
            "license": "847",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "025107100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Oxygen Equipment & Supplies (DME) in Cutler Bay, FL
• Providers in Cutler Bay, FL by specialty
• Oxygen Equipment & Supplies (DME) in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.