Managed Healthcare Medical Group LLC

Primary specialty

Exclusive Provider OrganizationTaxonomy code 302F00000X

Legal business name

MANAGED HEALTHCARE MEDICAL GROUP LLC

Practice address

150 S Pine Island Rd Ste 300
Plantation, FL 33324-2665

Phone

(754) 224-9333

Fax

(954) 337-8265

NPI assigned

Mar 16, 2023

Organization subpart

No

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

Authorized official

Name

Lucinda Blunt

Title

Ceo

Phone

(754) 224-9333

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1678924800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678924800000",
    "number": "1255032025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 S PINE ISLAND RD STE 300",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333242665",
            "telephone_number": "754-224-9333",
            "fax_number": "954-337-8265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 S PINE ISLAND RD STE 300",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333242665",
            "telephone_number": "754-224-9333",
            "fax_number": "954-337-8265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MANAGED HEALTHCARE MEDICAL GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-16",
        "last_updated": "2023-03-16",
        "certification_date": "2023-03-16",
        "status": "A",
        "authorized_official_last_name": "BLUNT",
        "authorized_official_first_name": "LUCINDA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "754-224-9333"
    },
    "taxonomies": [
        {
            "code": "302F00000X",
            "taxonomy_group": "",
            "desc": "Exclusive Provider Organization",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tracy Mallett, PSYD
• Roshni Mallick, DO
• Gary W Mallow, M.D.
• Dana Malzahn
• Kyndall Nyeschelle Mammah, FNP
• Sebastian Meis Austria Manahan, DO
• Vivek Manda
• Amulya Mandavalli
• Mayur Maniar, MD
• Mankame, Dipak M., D.D.S., P.a.

• Exclusive Provider Organization in Plantation, FL
• Providers in Plantation, FL by specialty
• Exclusive Provider Organization in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2023; 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.