| Mgh Medical Group Oh Llc | |
|
515 S Federal Hwy Deerfield Beach FL 33441-4109 | |
| (954) 667-5465 | |
| (412) 451-8656 |
| Full Name | Mgh Medical Group Oh Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 515 S Federal Hwy, Deerfield Beach, Florida |
| Authorized Official Name and Position | Geminisa Solorzano (CRCO-REVENUE CYCLE DIRECTOR) |
| Authorized Official Contact | 9546675465 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mgh Medical Group Oh Llc 530 S Federal Hwy Deerfield Beach FL 33441-4140 Ph: (954) 667-5465 | Mgh Medical Group Oh Llc 515 S Federal Hwy Deerfield Beach FL 33441-4109 Ph: (954) 667-5465 |
| NPI Number | 1326890336 |
|---|---|
| Provider Enumeration Date | 04/03/2024 |
| Last Update Date | 08/16/2024 |
| Certification Date | 08/16/2024 |
| Medicare PECOS PAC ID | 6507397700 |
|---|---|
| Medicare Enrollment ID | O20240929000046 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326890336 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TP2701X | Psychologist - Group Psychotherapy | (* (Not Available)) | Secondary |
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Jonathan Snipes |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1821250077 PECOS PAC ID: 8123298254 Enrollment ID: I20220121000424 |
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