| Buen Pastor Medical Center | |
|
4400 Sheridan St Ste C Hollywood FL 33021-3514 | |
| (954) 882-0191 | |
| Not Available |
| Full Name | Buen Pastor Medical Center |
|---|---|
| Speciality | General Practice |
| Location | 4400 Sheridan St Ste C, Hollywood, Florida |
| Authorized Official Name and Position | Gabriel G Florez (PRESIDENT) |
| Authorized Official Contact | 9548820191 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Buen Pastor Medical Center 4400 Sheridan St Ste C Hollywood FL 33021-3514 Ph: (954) 882-0191 | Buen Pastor Medical Center 4400 Sheridan St Ste C Hollywood FL 33021-3514 Ph: (954) 882-0191 |
| NPI Number | 1184232522 |
|---|---|
| Provider Enumeration Date | 07/22/2020 |
| Last Update Date | 05/31/2023 |
| Medicare PECOS PAC ID | 4486071313 |
|---|---|
| Medicare Enrollment ID | O20200824002440 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184232522 | NPI | - | NPPES |
| HCC12260 | Other | FL | AHCA LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| Provider Name | Gabriel G Florez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1639379761 PECOS PAC ID: 4385719665 Enrollment ID: I20101228000302 |
| Provider Name | Josefina Lozano |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1457554297 PECOS PAC ID: 9032388459 Enrollment ID: I20110801000736 |
| Provider Name | Grisel De La Fe Perez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417590084 PECOS PAC ID: 6204264435 Enrollment ID: I20200321000071 |
| Provider Name | Juan Holguin De La Cruz |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1750569042 PECOS PAC ID: 8426137613 Enrollment ID: I20210115000719 |
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