THE MEDICAL GROUP OF SOUTH FLORIDA INC (NPI# 1104126952) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104126952 |
| Entity Type | Organization |
| Organization Name | THE MEDICAL GROUP OF SOUTH FLORIDA INC |
| Practice Address |
1094 Military Trl Jupiter FL 33458-7021 |
| Mailing Address |
1094 Military Trl Dept 4101 Jupiter FL 33458-7021 |
| Practice Telephone | 5616226111 |
| Practice Fax Number | 5616221176 |
| Mailing Telephone | 5616226111 |
| Mailing Fax Number | 5612463721 |
| Enumeration Date | 2010-10-27 |
| Last Update Date | 2018-09-04 |
| Authorized Official Name | DR. JOSHUA SMITH (OWNER) |
| Authorized Official Telephone | 5616226111 |
| Authorized Official Credential | DC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | BLUE SHIELD OF FLORIDA | 000S2 | 01 |
| FL | 002251800 | 05 | |
| FL | BCBS | 99567 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 4700 N Congress Ave Ste 103, West Palm Beach, FL 334073284 | 5612553131 | 8553463451 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700176013 | The Medical Group of South Florida Inc | Specialist | 4700 N Congress Ave, Ste 103, West Palm Beach, FL 33407-3282 | 2011-04-08 |
| 1548429186 | The Medical Group of South Florida Inc | Pain Medicine | 160 Nw Central Park Plz, Ste 101, Port Saint Lucie, FL 34986 | 2008-06-09 |
| 1225179450 | The Medical Group of South Florida Inc | Clinic/Center | 1094 Military Trl, Jupiter, FL 33458-7021 | 2007-02-09 |
| Street Address |
1094 MILITARY TRL |
| City | JUPITER |
| State | FL |
| Zip Code | 33458-7021 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760476477 | Avishai Mendelson | Internal Medicine | 1094 Military Trl, Jupiter, FL 33458 | 2005-09-08 |
| 1063939346 | Radiant Medical Group LLC | Health Maintenance Organization | 1094 Military Trl, Jupiter, FL 33458-7021 | 2017-08-28 |
| 1184047276 | The Medical Group of South Florida, Inc. | Specialist | 1094 Military Trl, Jupiter, FL 33458 | 2014-01-27 |
| 1194085415 | Isabel Bueno Acedo | Internal Medicine | 1094 Military Trl, Jupiter, FL 33458 | 2012-05-21 |
| 1801168281 | Isis Flavia Manhart | Internal Medicine | 1094 Military Trl, Jupiter, FL 33458 | 2012-02-01 |
| 1588977409 | Miral A Subhani | Internal Medicine | 1094 Military Trl, Jupiter, FL 33458 | 2010-07-20 |
| 1144458274 | Suzanne Carrie Fuchs | Podiatrist | 1094 Military Trl, Jupiter, FL 33458-7021 | 2009-06-26 |
| 1275761389 | Vishnu Seecharan | Podiatrist | 1094 Military Trl, Jupiter, FL 33458-7021 | 2009-06-26 |
| 1225179450 | The Medical Group of South Florida Inc | Clinic/Center | 1094 Military Trl, Jupiter, FL 33458-7021 | 2007-02-09 |
| 1023159373 | Seth D Smith | Chiropractor | 1094 Military Trl, Jupiter, FL 33458-7021 | 2007-02-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538780978 | Palm Beach Concierge Pt, LLC | Physical Therapist | 1166 Egret Cir S, Jupiter, FL 33458 | 2020-04-27 |
| 1346714789 | Shirley Dumas Gilbert | Counselor | 1132 W Indiantown Rd Unit 202, Jupiter, FL 33458 | 2019-01-18 |
| 1326518986 | Donald George Williams Jr. | Pharmacist | 5500 Military Trail, Jupiter, FL 33458 | 2018-11-27 |
| 1306329693 | William A Tison IIi | Physician Assistant | 2055 Military Trail Suite 204, Jupiter, FL 33458 | 2018-09-12 |
| 1588146930 | Joanna Peros | Psychologist | 210 Jupiter Lakes Blvd. Unit 3102, Jupiter, FL 33458 | 2018-09-02 |
| 1528558301 | Brian Pratt | Registered Nurse | 871 University Blvd Apt 207, Jupiter, FL 33458 | 2018-05-16 |
| 1306352133 | Katherine Janis Rivera | Nurse Anesthetist, Certified Registered | Jupiter Medical Center 1210 Old Dixie Hwy, Jupiter, FL 33458 | 2017-12-15 |
| 1992235436 | Barborka Schmidt | Pharmacist | 6650 W Indiantown Road, Suite 100, Aarav Pharmacy LLC, Jupiter, FL 33458 | 2017-06-18 |
| 1114453834 | Elite-e Counseling | Social Worker | 2055 Military Trail Suite 306 Jupiter, Jupiter, FL 33458 | 2017-05-02 |
| 1669910667 | Kristy Lee Caronia | Nurse Anesthetist, Certified Registered | 175 Edenberry Ave, Jupiter, FL 33458 | 2017-02-09 |
| Find all providers in zip 33458 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043818529 | Michele Rosenthal | Specialist | 425 Greenwich Circle, #107, Jupiter, FL 33458-4809 | 2020-10-15 |
| 1215383963 | Ralph Gardner | Specialist | 5500 Military Trl # 22-310, Jupiter, FL 33458-2869 | 2016-05-12 |
| 1962886481 | Katie Usher | Specialist | 155 Toney Penna Dr Ste 2, Jupiter, FL 33458-5746 | 2015-07-14 |
| 1043627664 | Sleep Enterprises LLC | Specialist | 601 Heritage Dr Ste 103a, Jupiter, FL 33458-2777 | 2014-07-15 |
| 1205269784 | Lisa Kleiman | Specialist | 118 Waters Edge Dr, Jupiter, FL 33477-4031 | 2013-08-19 |
| 1063702470 | Essam Attia, M.d., P.a. | Specialist | 210 Jupiter Lakes Blvd Ste 3201, Jupiter, FL 33458-7189 | 2011-04-19 |
| 1962632232 | Mahmood Ahmadi | Specialist | 128 S Hampton Dr, Jupiter, FL 33458-8103 | 2009-07-21 |
| 1568627891 | Reza Saffari Md Pa | Specialist | 166 Tuscan Circle, Jupiter, FL 33458 | 2008-07-25 |
| 1700045309 | Professional Audiology Associates | Specialist | 2103 S Us Highway 1, Jupiter, FL 33477-7321 | 2008-06-09 |
| 1447417068 | Nerisa Eva Martinez | Specialist | 6121 Lucerne St, Jupiter, FL 33458-6672 | 2008-05-21 |
| Find all providers in JUPITER | ||||
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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.