| Organization Name: | DIVERSIFIED MEDICAL GROUP, INC |
| NPI Number: | 1033286034 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | GABRIEL A DELGADO (PRESIDENT) |
| Mailing Address: | 18619 Sw 107th Ave Cutler Bay |
| State: | FL US |
| Postal Code: | 331576728 |
| Phone Number: | 3056628559 |
| Fax Number: | 3056676280 |
| NPI Enumeration Date: | 11/29/2006 |
| NPI Last Update Date: | 03/30/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 332BX2000X |
| License Number: | 847 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Suppliers |
| Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
| Taxonomy Specialization: | Oxygen Equipment & Supplies |
| Taxonomy Definition: | |