| Miami Health Center, Llc | |
|
19001 Sw 106th Ave Ste C-109 Cutler Bay FL 33157-7669 | |
| (305) 255-9806 | |
| (305) 255-9807 |
| Full Name | Miami Health Center, Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 19001 Sw 106th Ave Ste C-109, Cutler Bay, Florida |
| Authorized Official Name and Position | Odalys Santana (ADMINISTRATOR) |
| Authorized Official Contact | 3052559806 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Miami Health Center, Llc 19001 Sw 106th Ave Ste C-109 Cutler Bay FL 33157-7669 Ph: (305) 255-9806 | Miami Health Center, Llc 19001 Sw 106th Ave Ste C-109 Cutler Bay FL 33157-7669 Ph: (305) 255-9806 |
| NPI Number | 1083189013 |
|---|---|
| Provider Enumeration Date | 10/05/2018 |
| Last Update Date | 11/04/2022 |
| Certification Date | 11/04/2022 |
| Medicare PECOS PAC ID | 9234465444 |
|---|---|
| Medicare Enrollment ID | O20190725002832 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083189013 | NPI | - | NPPES |
| 104891200 | Medicaid | FL | |
| 106017200 | Medicaid | FL | |
| 101870800 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Carlos Jacinto Martinez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487011557 PECOS PAC ID: 1355632720 Enrollment ID: I20161018000006 |
| Provider Name | Roberto E Gimenez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508239872 PECOS PAC ID: 9830485291 Enrollment ID: I20170510002168 |
| Provider Name | Olga L Mendoza |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1306912878 PECOS PAC ID: 0941112387 Enrollment ID: I20190710002433 |
| Provider Name | Sabih Iqbal |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1205330024 PECOS PAC ID: 5395141097 Enrollment ID: I20210903001578 |
| Provider Name | Juan M Guzman Otero |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992314058 PECOS PAC ID: 7618365362 Enrollment ID: I20211028002322 |
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