| Carmona Medical Center | |
|
2307 Bolado Pkwy Cape Coral FL 33990-2712 | |
| (786) 768-3315 | |
| (239) 443-4516 |
| Full Name | Carmona Medical Center |
|---|---|
| Speciality | Family Medicine |
| Location | 2307 Bolado Pkwy, Cape Coral, Florida |
| Authorized Official Name and Position | Juan A Carmona (PRESIDENT) |
| Authorized Official Contact | 7867683315 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Carmona Medical Center 2307 Bolado Pkwy Cape Coral FL 33990-2712 Ph: (786) 768-3315 | Carmona Medical Center 2307 Bolado Pkwy Cape Coral FL 33990-2712 Ph: (786) 768-3315 |
| NPI Number | 1922620749 |
|---|---|
| Provider Enumeration Date | 05/14/2020 |
| Last Update Date | 08/31/2022 |
| Medicare PECOS PAC ID | 4486076080 |
|---|---|
| Medicare Enrollment ID | O20200629001829 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922620749 | NPI | - | NPPES |
| 2DYCQ | Other | FL | BCBS |
| 022660000 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Juan A Carmona |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1083153761 PECOS PAC ID: 7113189671 Enrollment ID: I20171226000334 |
| Provider Name | Belkys Porras Alonso |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922583061 PECOS PAC ID: 6103159843 Enrollment ID: I20200619001674 |
| Provider Name | Lianet Delia Leon Oliveros |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306433362 PECOS PAC ID: 5799182093 Enrollment ID: I20210929003027 |
| Provider Name | Taymi Milagros Rival Castillo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801465885 PECOS PAC ID: 0840687927 Enrollment ID: I20220419001850 |
| Provider Name | Damila Pina Betancourt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629799333 PECOS PAC ID: 8921470469 Enrollment ID: I20230210000555 |
| Provider Name | Daineris Crespo Velazco |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487330429 PECOS PAC ID: 1951758598 Enrollment ID: I20231103001868 |
| Provider Name | Florinda B Varona De La Pena |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972364529 PECOS PAC ID: 8022550698 Enrollment ID: I20240611001594 |
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