NPI 1003746777

Sun Grove Medical Group PLLC

Organisation General Practice Physician Miami, FL

Practice location

Address: 10339 SW 145th CT, Miami, FL 33186-6946
Phone: (787) 565-9062
Mailing address: PO Box 960183, Miami, FL 33296-0183

Authorised official

Name: Jorge Hernandez Canciobello
Title: Owner
Phone: (787) 565-9062

Registered specialties

General Practice Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 208D00000X

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Registry record

NPI: 1003746777
Entity type: Organization
NPI issued: 22 May 2026
Record last updated: 22 May 2026

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.