| Progressive Medical Center Inc | |
|
12595 Sw 137th Ave Ste 110 Miami FL 33186-4218 | |
| (305) 465-9379 | |
| (305) 203-4672 |
| Full Name | Progressive Medical Center Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 12595 Sw 137th Ave Ste 110, Miami, Florida |
| Authorized Official Name and Position | Manuel Gomez (PRESIDENT) |
| Authorized Official Contact | 3054659379 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Progressive Medical Center Inc 12595 Sw 137th Ave Ste 110 Miami FL 33186-4218 Ph: (305) 465-9379 | Progressive Medical Center Inc 12595 Sw 137th Ave Ste 110 Miami FL 33186-4218 Ph: (305) 465-9379 |
| NPI Number | 1013592195 |
|---|---|
| Provider Enumeration Date | 03/10/2021 |
| Last Update Date | 09/18/2024 |
| Certification Date | 09/18/2024 |
| Medicare PECOS PAC ID | 8820497423 |
|---|---|
| Medicare Enrollment ID | O20210602001819 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013592195 | NPI | - | NPPES |
| Provider Name | Mary J Miranda-tourino |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1750817292 PECOS PAC ID: 2567705718 Enrollment ID: I20190510000767 |
| Provider Name | Ernesto Guevara |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093342818 PECOS PAC ID: 5890115505 Enrollment ID: I20201019003232 |
| Provider Name | Raul Ulloa Valladares |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1922574185 PECOS PAC ID: 6507255536 Enrollment ID: I20211113000065 |
| Provider Name | Monica Estupinan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457034217 PECOS PAC ID: 7315391133 Enrollment ID: I20230928000232 |
| Provider Name | Eliana Szwarc |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1356028245 PECOS PAC ID: 0941659379 Enrollment ID: I20231211003637 |
| Provider Name | Yanet De La Tejera |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1285172569 PECOS PAC ID: 9032568217 Enrollment ID: I20231213001795 |
| Provider Name | Micaela S Benayoun |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1073116000 PECOS PAC ID: 0042669913 Enrollment ID: I20231218002750 |
| Provider Name | Gretzky K Fuentes |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1568178093 PECOS PAC ID: 7315397189 Enrollment ID: I20231220002706 |
| Provider Name | Yanet Perez Arias |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437846037 PECOS PAC ID: 2264884667 Enrollment ID: I20240122003334 |
| Provider Name | Dianelys Rodriguez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336907591 PECOS PAC ID: 0941640114 Enrollment ID: I20240505000083 |
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