Key West Medical Group P a

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

KEY WEST MEDICAL GROUP P A

Doing business as

Southern Medical Group

Practice address

1111 12TH St
Suite210
Key West, FL 33040-4088

Phone

(305) 296-2414

NPI assigned

Jan 18, 2007

Organization subpart

No

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

Authorized official

Name

Ms. Lisa Lacova

Title

Billing Manager

Phone

(954) 426-1186

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• SOUTHERN MEDICAL GROUP Doing business as

Locations

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

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1297382400000",
    "number": "1477605285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 12TH ST",
            "address_2": "SUITE210",
            "city": "KEY WEST",
            "state": "FL",
            "postal_code": "330404088",
            "telephone_number": "305-296-2414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 12TH ST",
            "address_2": "SUITE210",
            "city": "KEY WEST",
            "state": "FL",
            "postal_code": "330404088",
            "telephone_number": "305-296-2414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEY WEST MEDICAL GROUP P A",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-18",
        "last_updated": "2011-02-11",
        "status": "A",
        "authorized_official_last_name": "LACOVA",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "954-426-1186",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "067849000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SOUTHERN MEDICAL GROUP",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Key West Hma Physician Management LLC (Lower Keys Medical Center)
• Key West Hma Physician Management LLC (Keys Medical Group)
• Key West Hma Physician Management LLC (Keys Medical Group)
• Key West Hma Physician Management LLC (Keys Medical Group)
• Key West Institute of Plastic Surgery
• Key West Nursing Home Opco LLC
• Key West Nursing Home Propco LLC (Key West Care and Rehabilitation)
• Key West Orthopedics PA
• Key West Spine and Injury, Inc.
• Key West Surgical Group Inc

• Internal Medicine Physician in Key West, FL
• Providers in Key West, FL by specialty
• Internal Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2011; 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.