Provider Demographics
NPI:1760218317
Name:MD ON THE GO LLC
Entity type:Organization
Organization Name:MD ON THE GO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:
Authorized Official - Last Name:PEREA BARBOSA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-895-2091
Mailing Address - Street 1:3081 SALZEDO ST STE 202-Z
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-6722
Mailing Address - Country:US
Mailing Address - Phone:561-759-0043
Mailing Address - Fax:
Practice Address - Street 1:3081 SALZEDO ST STE 202-Z
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-6722
Practice Address - Country:US
Practice Address - Phone:561-759-0043
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-10
Last Update Date:2024-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty