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306 Alcazar Ave Ste 301 Coral Gables FL 33134-4318 | |
| (786) 359-4814 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Clinic/Center |
| Location | 306 Alcazar Ave Ste 301, Coral Gables, Florida |
| Authorized Official Name and Position | Vicente Sanchez (OWNER) |
| Authorized Official Contact | 7868890053 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
306 Alcazar Ave Ste 301 Coral Gables FL 33134-4318 Ph: (786) 359-4814 | 306 Alcazar Ave Ste 301 Coral Gables FL 33134-4318 Ph: (786) 359-4814 |
| NPI Number | 1194317669 |
|---|---|
| Provider Enumeration Date | 02/06/2021 |
| Last Update Date | 10/25/2023 |
| Certification Date | 10/25/2023 |
| Medicare PECOS PAC ID | 4385032457 |
|---|---|
| Medicare Enrollment ID | O20211021001908 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194317669 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Ramon M Hernandez |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1902819113 PECOS PAC ID: 3375513906 Enrollment ID: I20040729001224 |
| Provider Name | David Allan Marquis |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1679552400 PECOS PAC ID: 8820050826 Enrollment ID: I20041102000386 |
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