OrganizationActive
Illumina Medical Group Management, LLC
NPI 1104335314 · Clinic/Center · Doral, FL
Provider details
- NPI number
- 1104335314
- Entity type
- Organization
- Primary specialty
- Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Angel Mongeotti, Executive Director of Finance(305) 254-8900
Specialties & taxonomies
Ambulatory Health Care Facilities
Practice location
1914 Nw 84th Ave
Doral, FL 33126-1030
Phone: (305) 254-8900
Fax: (305) 254-8902
Approximate (ZIP-level) locationGet directions
Mailing address
1914 Nw 84th Ave
Doral, FL 33126-1030
Registry dates
- Enumerated
- 2017-09-20
- Last updated
- 2022-07-21
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.