Provider Demographics
NPI:1235936089
Name:HOLGUIN MEDICAL GROUP, LLC.
Entity type:Organization
Organization Name:HOLGUIN MEDICAL GROUP, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:DE LOS MILAGROS
Authorized Official - Last Name:JIMENEZ RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:754-210-5957
Mailing Address - Street 1:1000 N HIATUS RD STE 206
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33026-3026
Mailing Address - Country:US
Mailing Address - Phone:754-210-5957
Mailing Address - Fax:
Practice Address - Street 1:1000 N HIATUS RD STE 206
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33026-3026
Practice Address - Country:US
Practice Address - Phone:754-210-5957
Practice Address - Fax:754-241-9964
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-28
Last Update Date:2025-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty