Pro Life Medical Center Corp. | |
7925 Nw 12th St Ste 315 Doral FL 33126-1846 | |
(305) 965-1525 | |
Not Available |
Full Name | Pro Life Medical Center Corp. |
---|---|
Speciality | Community/Behavioral Health |
Location | 7925 Nw 12th St Ste 315, Doral, Florida |
Authorized Official Name and Position | Manuel Jose Amigo Guillen (OWNER) |
Authorized Official Contact | 3059651525 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Pro Life Medical Center Corp. 7925 Nw 12th St Ste 315 Doral FL 33126-1846 Ph: (305) 965-1525 | Pro Life Medical Center Corp. 7925 Nw 12th St Ste 315 Doral FL 33126-1846 Ph: (305) 965-1525 |
NPI Number | 1467045252 |
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Provider Enumeration Date | 02/12/2021 |
Last Update Date | 03/08/2024 |
Certification Date | 03/08/2024 |
Medicare PECOS PAC ID | 2062891047 |
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Medicare Enrollment ID | O20220622000950 |
Identifier | Type | State | Issuer |
---|---|---|---|
1467045252 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
103K00000X | Behavior Analyst | (* (Not Available)) | Secondary |
251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
Provider Name | Nirmal J. Joseph |
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Provider Type | Practitioner - Anesthesiology |
Provider Identifiers | NPI Number: 1790760643 PECOS PAC ID: 5890742654 Enrollment ID: I20050404000693 |
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