| Ocean Reef Medical Institute, Llc | |
|
4471 Nw 36th St Ste 230 Miami Springs FL 33166-7289 | |
| (786) 859-1918 | |
| Not Available |
| Full Name | Ocean Reef Medical Institute, Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 4471 Nw 36th St Ste 230, Miami Springs, Florida |
| Authorized Official Name and Position | Maria Amanda Trejos (OWNER/ MANAGER) |
| Authorized Official Contact | 7868591918 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ocean Reef Medical Institute, Llc 1138 W 41st St Hialeah FL 33012-4167 Ph: (786) 859-1918 | Ocean Reef Medical Institute, Llc 4471 Nw 36th St Ste 230 Miami Springs FL 33166-7289 Ph: (786) 859-1918 |
| NPI Number | 1821774126 |
|---|---|
| Provider Enumeration Date | 06/22/2023 |
| Last Update Date | 06/22/2023 |
| Certification Date | 06/22/2023 |
| Medicare PECOS PAC ID | 8628432317 |
|---|---|
| Medicare Enrollment ID | O20230913003972 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821774126 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Humberto J Hernandez |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1689647869 PECOS PAC ID: 7618953985 Enrollment ID: I20040628000256 |
| Provider Name | Alen Hidalgo |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1013368372 PECOS PAC ID: 4789050329 Enrollment ID: I20221021001957 |
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