| Ccg Of South Florida Llc | |
|
2901 Coral Hills Dr Suite 360 Coral Springs FL 33065-4146 | |
| (954) 255-7310 | |
| (954) 255-7311 |
| Full Name | Ccg Of South Florida Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 2901 Coral Hills Dr, Coral Springs, Florida |
| Authorized Official Name and Position | Mario B Pereira (PRESIDENT) |
| Authorized Official Contact | 9542557310 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ccg Of South Florida Llc 2901 Coral Hills Dr Suite 360 Coral Springs FL 33065-4146 Ph: (954) 255-7310 | Ccg Of South Florida Llc 2901 Coral Hills Dr Suite 360 Coral Springs FL 33065-4146 Ph: (954) 255-7310 |
| NPI Number | 1497034086 |
|---|---|
| Provider Enumeration Date | 08/12/2011 |
| Last Update Date | 08/12/2011 |
| Medicare PECOS PAC ID | 8022284173 |
|---|---|
| Medicare Enrollment ID | O20111220000755 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497034086 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Tatyana S Borisiak |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1659579795 PECOS PAC ID: 6103989033 Enrollment ID: I20090120000287 |
| Provider Name | Mario B Pereira |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1760680466 PECOS PAC ID: 0840356150 Enrollment ID: I20091022000703 |
| Provider Name | Abed Alhomsi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1124245782 PECOS PAC ID: 2163569179 Enrollment ID: I20091023000519 |
| Provider Name | Deborah Marie Charvat |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255651212 PECOS PAC ID: 9234261603 Enrollment ID: I20100720001042 |
| Provider Name | Saira Hussain |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1538466412 PECOS PAC ID: 1759539067 Enrollment ID: I20120911000684 |
| Provider Name | Bryan M Dawkins |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1851611768 PECOS PAC ID: 7810125531 Enrollment ID: I20131231001960 |
| Provider Name | Ashkan Jafarbay |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1114999695 PECOS PAC ID: 1557344645 Enrollment ID: I20140131001155 |
| Provider Name | Valerie J Eyma-heywood |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1821107731 PECOS PAC ID: 9931205564 Enrollment ID: I20150504000440 |
| Provider Name | Deborah Dicastro-schaffer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003091737 PECOS PAC ID: 9638472152 Enrollment ID: I20160115001957 |
| Provider Name | Elijah Obiero |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578914271 PECOS PAC ID: 7315234457 Enrollment ID: I20160917000301 |
| Provider Name | Samreen Masood |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1497174486 PECOS PAC ID: 7618249350 Enrollment ID: I20170816000553 |
| Provider Name | Murielle Pierre-joachim |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528509585 PECOS PAC ID: 6204109036 Enrollment ID: I20170830001241 |
| Provider Name | Natalia Lukonina Swaebe |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1891114823 PECOS PAC ID: 5395011811 Enrollment ID: I20171026003345 |
| Provider Name | Lesly Silva |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1700316379 PECOS PAC ID: 1850663709 Enrollment ID: I20200518000231 |
| Provider Name | Jennifer Piraino |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528684602 PECOS PAC ID: 4587082607 Enrollment ID: I20200922000486 |
| Provider Name | Vanessa Salinas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265017594 PECOS PAC ID: 1557753019 Enrollment ID: I20220113002498 |
| Provider Name | Stephanie Leavitt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760967012 PECOS PAC ID: 1355723222 Enrollment ID: I20220809002987 |
| Provider Name | Nathan M Zaher |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1518522572 PECOS PAC ID: 3476889353 Enrollment ID: I20220819001670 |
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