| Community Medical Group | |
|
394 Havendale Blvd Auburndale FL 33823-4527 | |
| (863) 327-0131 | |
| (863) 777-2307 |
| Full Name | Community Medical Group |
|---|---|
| Speciality | Family Medicine |
| Location | 394 Havendale Blvd, Auburndale, Florida |
| Authorized Official Name and Position | Rayny Ramirez (PRESIDENT) |
| Authorized Official Contact | 7863227333 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Community Medical Group 6100 Blue Lagoon Dr Ste 365 Miami FL 33126-7010 Ph: (786) 322-7333 | Community Medical Group 394 Havendale Blvd Auburndale FL 33823-4527 Ph: (863) 327-0131 |
| NPI Number | 1831609684 |
|---|---|
| Provider Enumeration Date | 10/06/2017 |
| Last Update Date | 05/01/2024 |
| Medicare PECOS PAC ID | 2062846934 |
|---|---|
| Medicare Enrollment ID | O20191231001035 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831609684 | NPI | - | NPPES |
| 104441500 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Edda Hebertina Tortolero |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922422880 PECOS PAC ID: 4284855834 Enrollment ID: I20141023000731 |
| Provider Name | Cynthia I Diaz Pineiro |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750821344 PECOS PAC ID: 1254692288 Enrollment ID: I20180307001828 |
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