ETERNITY MEDICAL GROUP CORP; NPI #1083216022

Contact Information

ETERNITY MEDICAL GROUP CORP

900 SW 8TH ST STE C1
MIAMI, FL 33130-3756

Phone: 786-332-3136
Fax: 305-726-0013
Website:

Specialty	Taxonomy Code	Specialty Code	Provider Type
Clinic/Center	261Q00000X
Adult Mental Health	261QM0850X
Clinical Medical Laboratory	291U00000X	69	Clinical Laboratory
Community/Behavioral Health	251S00000X
Mental Health (Including Community Mental Health Center)	261QM0801X	B4[14]	Community Mental Health Center
Multi-Specialty	261QM1300X	70	Clinic or Group Practice
Primary Care	261QP2300X

Indicates primary specialty

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NPI Profile & details for ETERNITY MEDICAL GROUP CORP

NPI # 1083216022

LBN Legal business name ETERNITY MEDICAL GROUP CORP

Authorized official LUIS AGUILAR - (OWNER/PRESIDENT)

Entity Organization

Organization subpart ¹ No

Enumeration date 11/13/2020

Last updated 08/14/2025 - About 10 months ago

Identifiers

FL	Medicaid	108835400
FL	Other	13052	HEALTH CARE CLINIC STANDARD LICENSE

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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