Provider Demographics
NPI:1689498875
Name:SOUTHWEST MEDICAL GROUP, P.A
Entity type:Organization
Organization Name:SOUTHWEST MEDICAL GROUP, P.A
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:FELIX
Authorized Official - Middle Name:ALEJANDRO
Authorized Official - Last Name:RAMIREZ LABRADA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:786-339-5074
Mailing Address - Street 1:750 E SAMPLE RD
Mailing Address - Street 2:BLDG 3 SUITE 6
Mailing Address - City:POMPANO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33064
Mailing Address - Country:US
Mailing Address - Phone:754-732-2444
Mailing Address - Fax:754-732-6292
Practice Address - Street 1:750 E SAMPLE RD
Practice Address - Street 2:BLDG 3 SUITE 6
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33064
Practice Address - Country:US
Practice Address - Phone:754-732-2444
Practice Address - Fax:754-732-6292
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SOUTHWEST MEDICAL GROUP, P.A
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-11-13
Last Update Date:2024-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care