| Als Medical Group Miami Gardens Llc | |
|
4888 Nw 183rd St Ste 112 Miami Gardens FL 33055-2940 | |
| (305) 317-3948 | |
| (305) 549-5314 |
| Full Name | Als Medical Group Miami Gardens Llc |
|---|---|
| Speciality | General Practice |
| Location | 4888 Nw 183rd St Ste 112, Miami Gardens, Florida |
| Authorized Official Name and Position | Maricela Nicolas (OWNER) |
| Authorized Official Contact | 3053039154 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Als Medical Group Miami Gardens Llc 4888 Nw 183rd St Ste 112 Miami Gardens FL 33055-2940 Ph: (305) 317-3948 | Als Medical Group Miami Gardens Llc 4888 Nw 183rd St Ste 112 Miami Gardens FL 33055-2940 Ph: (305) 317-3948 |
| NPI Number | 1427789601 |
|---|---|
| Provider Enumeration Date | 06/20/2022 |
| Last Update Date | 10/24/2022 |
| Medicare PECOS PAC ID | 0547642738 |
|---|---|
| Medicare Enrollment ID | O20220804001853 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427789601 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| Provider Name | Thomas D Riley |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1558681817 PECOS PAC ID: 9133368590 Enrollment ID: I20151118002568 |
| Provider Name | Zoila E Anta Vergara |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821557323 PECOS PAC ID: 0042647513 Enrollment ID: I20200221001275 |
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