1st Care Case Management Services Llc | |
1400 Nw 107th Ave Ste 310 Sweetwater FL 33172-2746 | |
(786) 542-5043 | |
(786) 542-5049 |
Full Name | 1st Care Case Management Services Llc |
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Speciality | Clinic/Center |
Location | 1400 Nw 107th Ave Ste 310, Sweetwater, Florida |
Authorized Official Name and Position | Alexander Mata (PRESIDENT) |
Authorized Official Contact | 7865425043 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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1st Care Case Management Services Llc 1400 Nw 107th Ave Ste 310 Sweetwater FL 33172-2746 Ph: (786) 542-5043 | 1st Care Case Management Services Llc 1400 Nw 107th Ave Ste 310 Sweetwater FL 33172-2746 Ph: (786) 542-5043 |
NPI Number | 1518472414 |
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Provider Enumeration Date | 12/13/2017 |
Last Update Date | 01/23/2024 |
Certification Date | 01/23/2024 |
Medicare PECOS PAC ID | 1355752338 |
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Medicare Enrollment ID | O20201123002689 |
Identifier | Type | State | Issuer |
---|---|---|---|
1518472414 | NPI | - | NPPES |
107235000 | Medicaid | FL | |
116958500 | Medicaid | FL | |
023273200 | Medicaid | FL |
Provider Name | Magdiel Diaz |
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Provider Type | Practitioner - General Practice |
Provider Identifiers | NPI Number: 1518942812 PECOS PAC ID: 1951383330 Enrollment ID: I20040601001406 |
Provider Name | Adriana Gonzalez |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1588191308 PECOS PAC ID: 3577697259 Enrollment ID: I20180221002609 |
Provider Name | Vivian Blanco Lezcano |
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Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1225489180 PECOS PAC ID: 5799109591 Enrollment ID: I20231116003088 |
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