| First Response Leads Llc | |
|
12900 Sw 128th St Ste 204b Miami FL 33186-6274 | |
| (786) 227-6020 | |
| (786) 544-2790 |
| Full Name | First Response Leads Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 12900 Sw 128th St Ste 204b, Miami, Florida |
| Authorized Official Name and Position | Juan Velasquez (PRESIDENT) |
| Authorized Official Contact | 7862276020 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| First Response Leads Llc 12900 Sw 128th St Ste 204b Miami FL 33186-6274 Ph: (786) 227-6020 | First Response Leads Llc 12900 Sw 128th St Ste 204b Miami FL 33186-6274 Ph: (786) 227-6020 |
| NPI Number | 1609559541 |
|---|---|
| Provider Enumeration Date | 08/08/2023 |
| Last Update Date | 12/12/2023 |
| Medicare PECOS PAC ID | 6305295767 |
|---|---|
| Medicare Enrollment ID | O20231211000999 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609559541 | NPI | - | NPPES |
| 11020559 | Other | FL | MEDICAL LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
| Provider Name | Luis M Campillo |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1922054352 PECOS PAC ID: 7113812413 Enrollment ID: I20040217000093 |
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