Mdlive Medical Group Il LLC

NPI #1346957545 in Miramar, Florida

Provider Information

NPI Number: 1346957545
Entity Type: Organization
Organization Name: Mdlive Medical Group Il LLC
Subpart: Yes (part of a larger organization)
Parent Organization: MDLIVE MEDICAL GROUP IL LLC
Primary Specialty: Dermatology
Enumeration Date: Oct 28, 2022
Last Updated: Oct 28, 2022

Practice Location

Address: 3350 SW 148TH AVE STE 300
City: Miramar
State: Florida
ZIP Code: 33027-3259
Phone: (800) 400-6354

Authorized Official

Name: MERRY SCHUMACHER
Title: SR. DIRECTOR PROVIDER SERVICES
Phone: (800) 400-6354

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X
Nurse Practitioner	363L00000X
Dermatology	207N00000X	Primary

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