New Wave Medical Group PA

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

Legal business name

NEW WAVE MEDICAL GROUP PA

Practice address

9018 60TH Ave E
Bradenton, FL 34202-9642

Phone

(844) 327-2199

NPI assigned

Mar 16, 2022

Last updated

Jan 27, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dalia Elizalde

Title

Manager

Phone

(844) 327-2199

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1647388800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1674777600000",
    "number": "1912655069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9018 60TH AVE E",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342029642",
            "telephone_number": "844-327-2199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9018 60TH AVE E",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342029642",
            "telephone_number": "844-327-2199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW WAVE MEDICAL GROUP PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-16",
        "last_updated": "2023-01-27",
        "certification_date": "2023-01-27",
        "status": "A",
        "authorized_official_last_name": "ELIZALDE",
        "authorized_official_first_name": "DALIA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "844-327-2199"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Multi-Specialty Clinic/Center in Bradenton, FL
• Providers in Bradenton, FL by specialty
• Multi-Specialty Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 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.