| Gardens Medical Center, Llc | |
|
12963 W Okeechobee Rd Unit 3 Hialeah Gardens FL 33018-6055 | |
| (786) 450-9918 | |
| Not Available |
| Full Name | Gardens Medical Center, Llc |
|---|---|
| Speciality | Case Management |
| Location | 12963 W Okeechobee Rd, Hialeah Gardens, Florida |
| Authorized Official Name and Position | Ofrey E Hernandez (OWNER) |
| Authorized Official Contact | 7864509918 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gardens Medical Center, Llc 12963 W Okeechobee Rd Unit 3 Hialeah Gardens FL 33018-6055 Ph: (786) 450-9918 | Gardens Medical Center, Llc 12963 W Okeechobee Rd Unit 3 Hialeah Gardens FL 33018-6055 Ph: (786) 450-9918 |
| NPI Number | 1235828567 |
|---|---|
| Provider Enumeration Date | 05/03/2023 |
| Last Update Date | 04/10/2024 |
| Certification Date | 04/10/2024 |
| Medicare PECOS PAC ID | 9335596394 |
|---|---|
| Medicare Enrollment ID | O20231113002177 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235828567 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Secondary |
| 251B00000X | Case Management | (* (Not Available)) | Primary |
| Provider Name | Tae Y Kim |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1962906487 PECOS PAC ID: 7517368798 Enrollment ID: I20210624003411 |
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