| Caremax Medical Center Of Broward Llc | |
|
4302 W Broward Blvd Plantation FL 33317-3780 | |
| (954) 644-8902 | |
| (877) 967-5710 |
| Full Name | Caremax Medical Center Of Broward Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 4302 W Broward Blvd, Plantation, Florida |
| Authorized Official Name and Position | Carlos De Solo (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 3056498100 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Caremax Medical Center Of Broward Llc 1000 Nw 57th Ct Ste 400 Miami FL 33126-3292 Ph: (305) 649-8100 | Caremax Medical Center Of Broward Llc 4302 W Broward Blvd Plantation FL 33317-3780 Ph: (954) 644-8902 |
| NPI Number | 1871937987 |
|---|---|
| Provider Enumeration Date | 04/19/2013 |
| Last Update Date | 08/13/2024 |
| Medicare PECOS PAC ID | 5496053340 |
|---|---|
| Medicare Enrollment ID | O20160411001049 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871937987 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| 305S00000X | Point Of Service | (* (Not Available)) | Secondary |
| Provider Name | Juliet M Interiano |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396086724 PECOS PAC ID: 3274772165 Enrollment ID: I20130626000242 |
| Provider Name | Raul Calderin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1063729374 PECOS PAC ID: 8921226648 Enrollment ID: I20140821001455 |
| Provider Name | Javier Espinal |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1023326410 PECOS PAC ID: 9638498678 Enrollment ID: I20150424001531 |
| Provider Name | Jones Cemelus |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1154782043 PECOS PAC ID: 5294091476 Enrollment ID: I20171103000159 |
| Provider Name | Danilo Morejon Carbonell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437727948 PECOS PAC ID: 1557767514 Enrollment ID: I20210831002035 |
| Provider Name | Nicolas Applyrs |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1386208015 PECOS PAC ID: 8426446527 Enrollment ID: I20211021002931 |
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