| Cms/mch Primary Care Program | |
|
3100 Sw 62nd Ave Cottage #5 Miami FL 33155-3009 | |
| (786) 624-2490 | |
| (786) 624-5790 |
| Full Name | Cms/mch Primary Care Program |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 3100 Sw 62nd Ave, Miami, Florida |
| Authorized Official Name and Position | Manuella Janvier-anglade (PROJECT ADMINISTRATOR) |
| Authorized Official Contact | 7866242490 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Cms/mch Primary Care Program 3100 Sw 62nd Ave Cottage #5 Miami FL 33155-3009 Ph: (786) 624-2490 | Cms/mch Primary Care Program 3100 Sw 62nd Ave Cottage #5 Miami FL 33155-3009 Ph: (786) 624-2490 |
| NPI Number | 1235173402 |
|---|---|
| Provider Enumeration Date | 06/16/2006 |
| Last Update Date | 06/13/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235173402 | NPI | - | NPPES |
| 010060909 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | N/A (* (Not Available)) | Primary |
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