| Alive And Well Community Partners Llc | |
|
18425 Nw 2nd Ave 5th Floor Ph 7 Miami Gardens FL 33169 | |
| (800) 434-1366 | |
| Not Available |
| Full Name | Alive And Well Community Partners Llc |
|---|---|
| Speciality | General Practice |
| Location | 18425 Nw 2nd Ave 5th Floor Ph 7, Miami Gardens, Florida |
| Authorized Official Name and Position | Calvanetta Franklin (MANAGING MEMBER) |
| Authorized Official Contact | 8004341366 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Alive And Well Community Partners Llc 18425 Nw 2nd Ave 5th Floor Ph 7 Miami Gardens FL 33169 Ph: (800) 434-1366 | Alive And Well Community Partners Llc 18425 Nw 2nd Ave 5th Floor Ph 7 Miami Gardens FL 33169 Ph: (800) 434-1366 |
| NPI Number | 1043804461 |
|---|---|
| Provider Enumeration Date | 02/25/2021 |
| Last Update Date | 03/19/2024 |
| Medicare PECOS PAC ID | 4587064423 |
|---|---|
| Medicare Enrollment ID | O20210614002687 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043804461 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| Provider Name | Alicia Chilito |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1780632612 PECOS PAC ID: 5193715431 Enrollment ID: I20040517001428 |
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