INDEPENDENT MEDICAL GROUP, LLC. (NPI# 1558906800) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558906800 |
| Entity Type | Organization |
| Organization Name | INDEPENDENT MEDICAL GROUP, LLC. |
| Practice Address |
1409 Ne 26th St Wilton Manors FL 33305 |
| Mailing Address |
3800 Inverrary Blvd Ste 400r Lauderhill FL 33319-4359 |
| Practice Telephone | 9543197121 |
| Mailing Telephone | 9543197121 |
| Enumeration Date | 2019-11-11 |
| Last Update Date | 2019-11-11 |
| Authorized Official Name | STEVE VIXAMAR (COO) |
| Authorized Official Telephone | 9543197121 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QH0100X |
Clinic/Center Specialization: Health Service |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Independent Medical Group, LLC. | Other Name - Individual/Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1250 Nw 7th Unit 101-102, Miami, FL 33125 | 9543197121 | |
| 3800 Inverrary Blvd. #400r, Lauderhill, FL 33319 | 9543197121 | |
| 60 Ne 1st., Pompano Beach, FL 33060 | 9543197121 | |
| 7142 N. University, Tamarac, FL 33321 | 9543197121 |
| Street Address |
1409 NE 26TH ST |
| City | WILTON MANORS |
| State | FL |
| Zip Code | 33305 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316182538 | Pronto-med Inc | Pharmacy | 1409 Ne 26th St, Wilton Manors, FL 33305-1321 | 2008-12-03 |
| 1740554724 | Pronto-med Inc | Pharmacy | 1409 Ne 26th St, Wilton Manors, FL 33305-1321 | 2012-03-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982244331 | Michael Moses Gans | Social Worker | 520 Ne 20th Street, #603, Wilton Manors, FL 33305 | 2020-01-14 |
| 1922650159 | Samantha Jones | Chiropractor | 1732 Ne 26th St Ste 201, Wilton Manors, FL 33305 | 2019-07-09 |
| 1033601653 | Neuro Intergration LLC | Psychologist | 2500 N Federal Hwy Ste 100, Fort Lauderdale, FL 33305 | 2018-05-30 |
| 1548775000 | Inbox Inc. | Counselor | 1650 Ne 26th St., Suite 206, Wilton Manors, FL 33305 | 2017-12-06 |
| 1306394168 | The 5 Elements Spa & Longevity Center | Health Maintenance Organization | 2288 Wilton Drive, Wilton Manors, FL 33305 | 2016-09-21 |
| 1467900449 | Crystal L Cacolici | Acupuncturist | 1732 Ne 26th St Ste 202, Wilton Manors, FL 33305 | 2016-09-19 |
| 1649634809 | Terri-ann Brown Arnp | Nurse Practitioner | 1881 Ne 26th Street, Suite 102, Fort Lauderdale, FL 33305 | 2016-04-13 |
| 1194130203 | Rhea Butchey | Optometrist | 2131 N Federal Hwy, Fort Lauderdale, FL 33305 | 2014-06-26 |
| 1891128732 | Ashton Pierce Thompson | Internal Medicine | 2449 Ne 13th Ave, Wilton Manors, FL 33305 | 2013-08-14 |
| 1427300789 | Kids In Distress | Foster Care Agency | 819 Ne 26th St., Ft. Laud, FL 33305 | 2012-10-11 |
| Find all providers in zip 33305 | ||||
| Taxonomy Code | 261QH0100X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Health Service |
| Definition to come... |
| Notes: [7/1/2006: modified title] |
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| 1285249987 | Derma Beauty Spa Medical Clinic | Clinic/Center | 1470 Nw 107th Ave Ste M, Sweetwater, FL 33172-2735 | 2020-09-10 |
| 1225642622 | Dor Medical Services | Clinic/Center | 103 Landings Blvd, Greenacres, FL 33413-2027 | 2020-09-02 |
| 1952915563 | Ngozi Global Healthcare | Clinic/Center | 626 Eastwood Ct, Altamonte Springs, FL 32714-7304 | 2020-09-01 |
| Find all providers with the same taxonomy | ||||
| City | WILTON MANORS |
| Zip Code | 33305 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.