| Bewell Medical Center Llc | |
|
4700 Sheridan St Ste R Hollywood FL 33021-3416 | |
| (786) 797-9475 | |
| Not Available |
| Full Name | Bewell Medical Center Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 4700 Sheridan St Ste R, Hollywood, Florida |
| Authorized Official Name and Position | Jany Gonzalez (OWNER) |
| Authorized Official Contact | 7867979475 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bewell Medical Center Llc 7012 Nw 179th St Apt 208 Hialeah FL 33015-5416 Ph: (786) 797-9475 | Bewell Medical Center Llc 4700 Sheridan St Ste R Hollywood FL 33021-3416 Ph: (786) 797-9475 |
| NPI Number | 1275214744 |
|---|---|
| Provider Enumeration Date | 07/27/2023 |
| Last Update Date | 07/27/2023 |
| Medicare PECOS PAC ID | 9638529431 |
|---|---|
| Medicare Enrollment ID | O20231220000034 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275214744 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Jany Gonzalez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861038267 PECOS PAC ID: 2567862303 Enrollment ID: I20210615003121 |
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