| Community Medical Group | |
|
12376 Quail Roost Dr Miami FL 33177-4974 | |
| (786) 237-3070 | |
| (786) 430-8198 |
| Full Name | Community Medical Group |
|---|---|
| Speciality | Family Medicine |
| Location | 12376 Quail Roost Dr, Miami, Florida |
| Authorized Official Name and Position | Rayny Ramirez (PRESIDENT) |
| Authorized Official Contact | 7863227333 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Community Medical Group 6100 Blue Lagoon Dr Suite 365 Miami FL 33126-2079 Ph: (786) 322-7333 | Community Medical Group 12376 Quail Roost Dr Miami FL 33177-4974 Ph: (786) 237-3070 |
| NPI Number | 1578845129 |
|---|---|
| Provider Enumeration Date | 09/09/2011 |
| Last Update Date | 05/25/2023 |
| Medicare PECOS PAC ID | 4082851811 |
|---|---|
| Medicare Enrollment ID | O20130514000616 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578845129 | NPI | - | NPPES |
| 009426803 | Medicaid | FL | |
| 009426800 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Juan Antonio Cruz |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1639166044 PECOS PAC ID: 2769482587 Enrollment ID: I20061229000355 |
| Provider Name | Yoryana Vaquer Villazon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366863326 PECOS PAC ID: 4880811462 Enrollment ID: I20140805001024 |
| Provider Name | Caridad Sol Loeffler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386074649 PECOS PAC ID: 4981825791 Enrollment ID: I20141021000221 |
| Provider Name | Regla Maria Casola |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689086647 PECOS PAC ID: 5597086850 Enrollment ID: I20150611002142 |
| Provider Name | Anisia M Otero |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1811313190 PECOS PAC ID: 7214258243 Enrollment ID: I20160802001994 |
| Provider Name | Jesus G Noguer |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1043627128 PECOS PAC ID: 6002037389 Enrollment ID: I20160830002559 |
| Provider Name | Lenier Perez Miranda |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1578982179 PECOS PAC ID: 4385904903 Enrollment ID: I20180130001912 |
| Provider Name | Luis N Ramirez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871128579 PECOS PAC ID: 0749603082 Enrollment ID: I20200706001620 |
| Provider Name | Adalberto Machin Leon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033697651 PECOS PAC ID: 8628441045 Enrollment ID: I20230307000277 |
| Provider Name | Andres Hernandez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558964304 PECOS PAC ID: 9335151125 Enrollment ID: I20230319000031 |
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