| Carevantage Medical Centers Of Miami At Hialeah Llc | |
|
4445 West 16th Avenue Suite 501 Hialeah FL 33012-3205 | |
| (305) 558-8687 | |
| (305) 558-8097 |
| Full Name | Carevantage Medical Centers Of Miami At Hialeah Llc |
|---|---|
| Speciality | General Practice |
| Location | 4445 West 16th Avenue, Hialeah, Florida |
| Authorized Official Name and Position | Alberto Lamadrid (CFO) |
| Authorized Official Contact | 7866911110 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Carevantage Medical Centers Of Miami At Hialeah Llc 4445 West 16th Avenue Suite 501 Hialeah FL 33012-3205 Ph: (305) 558-8687 | Carevantage Medical Centers Of Miami At Hialeah Llc 4445 West 16th Avenue Suite 501 Hialeah FL 33012-3205 Ph: (305) 558-8687 |
| NPI Number | 1982971867 |
|---|---|
| Provider Enumeration Date | 11/21/2011 |
| Last Update Date | 08/10/2021 |
| Medicare PECOS PAC ID | 6002043163 |
|---|---|
| Medicare Enrollment ID | O20131216001869 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982971867 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| Provider Name | Noel E Lezama |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1275693137 PECOS PAC ID: 5799708731 Enrollment ID: I20060105000438 |
| Provider Name | Damian Vega Torres |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518656214 PECOS PAC ID: 3173980422 Enrollment ID: I20230601002126 |
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