| La Capital Medical Center | |
|
1550 W 84th St Ste 31 Hialeah FL 33014-3355 | |
| (305) 901-1191 | |
| (786) 615-5635 |
| Full Name | La Capital Medical Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 1550 W 84th St Ste 31, Hialeah, Florida |
| Authorized Official Name and Position | Isis Masson (PRESIDENT) |
| Authorized Official Contact | 3059011191 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| La Capital Medical Center 1550 W 84th St Ste 31 Hialeah FL 33014 Ph: (305) 742-5163 | La Capital Medical Center 1550 W 84th St Ste 31 Hialeah FL 33014-3355 Ph: (305) 901-1191 |
| NPI Number | 1356932586 |
|---|---|
| Provider Enumeration Date | 01/31/2021 |
| Last Update Date | 11/28/2022 |
| Certification Date | 11/21/2022 |
| Medicare PECOS PAC ID | 5092104216 |
|---|---|
| Medicare Enrollment ID | O20211109003396 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356932586 | NPI | - | NPPES |
| Provider Name | Juan C Abreu |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1043269863 PECOS PAC ID: 1355327289 Enrollment ID: I20040629001360 |
| Provider Name | Kevin Fitzgerald |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1891923744 PECOS PAC ID: 6204980717 Enrollment ID: I20160822001548 |
| Provider Name | Yudith Lopez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356013692 PECOS PAC ID: 5294112710 Enrollment ID: I20220521000161 |
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