Southern Florida Medical Group

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

ME95736 Issued in FL

Legal business name

SOUTHERN FLORIDA MEDICAL GROUP

Practice address

6399 SW 120TH St
Miami, FL 33156-4832

Phone

(305) 519-1447

NPI assigned

Apr 13, 2016

Organization subpart

No

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

Authorized official

Name

Gamal Wazni, MD

Title

Member

Phone

(586) 243-5225

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1460505600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1460505600000",
    "number": "1619331808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3657 MADACA LN",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336182048",
            "telephone_number": "586-243-5225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6399 SW 120TH ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331564832",
            "telephone_number": "305-519-1447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN FLORIDA MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-13",
        "last_updated": "2016-04-13",
        "status": "A",
        "authorized_official_last_name": "WAZNI",
        "authorized_official_first_name": "GAMAL",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "586-243-5225",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME95736",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Southeastern Med-Service Specialists, Inc.
• Southeastrern Dental Assoc, VII, PA
• Southern Advances Inc
• Southern Clinical Research, LLC
• Southern Florida Healthcare Services, LLC
• Southern Flow Logistics LLC
• Southern Medical Supply USA Inc
• Southern United Management Group Inc
• Southern Wound Care LLC
• Southgate Medical of Florida, Inc.

• Internal Medicine Physician in Miami, FL
• Providers in Miami, 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 Apr 13, 2016; 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.