Provider Demographics
NPI:1013629815
Name:SOUTHERN WINDS PHYSICIANS GROUP LLC
Entity type:Organization
Organization Name:SOUTHERN WINDS PHYSICIANS GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:
Authorized Official - Last Name:BRICK-TURIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-864-9191
Mailing Address - Street 1:10800 BISCAYNE BLVD STE 600
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33161-7499
Mailing Address - Country:US
Mailing Address - Phone:305-864-9191
Mailing Address - Fax:305-864-6667
Practice Address - Street 1:4225 W 20TH AVE
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-5826
Practice Address - Country:US
Practice Address - Phone:786-828-7552
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-23
Last Update Date:2022-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty