| Fuentes Medical Center Inc | |
|
18400 Nw 75th Pl Ste 116 Hialeah FL 33015-2956 | |
| (786) 584-8531 | |
| (305) 640-5776 |
| Full Name | Fuentes Medical Center Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 18400 Nw 75th Pl Ste 116, Hialeah, Florida |
| Authorized Official Name and Position | Pedro Luis Camejo (PRESIDENT) |
| Authorized Official Contact | 7865848531 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Fuentes Medical Center Inc 18400 Nw 75th Pl Ste 116 Hialeah FL 33015-2956 Ph: (786) 584-8531 | Fuentes Medical Center Inc 18400 Nw 75th Pl Ste 116 Hialeah FL 33015-2956 Ph: (786) 584-8531 |
| NPI Number | 1780260224 |
|---|---|
| Provider Enumeration Date | 03/23/2021 |
| Last Update Date | 08/04/2022 |
| Certification Date | 08/04/2022 |
| Medicare PECOS PAC ID | 3072913508 |
|---|---|
| Medicare Enrollment ID | O20210621001196 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780260224 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Jose Guillermo Alvarez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1205873817 PECOS PAC ID: 4587643580 Enrollment ID: I20040911000009 |
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