| Community Medical Group | |
|
1621 Sw 107th Ave Miami FL 33165-7344 | |
| (786) 422-6525 | |
| (786) 422-6535 |
| Full Name | Community Medical Group |
|---|---|
| Speciality | Family Medicine |
| Location | 1621 Sw 107th Ave, Miami, 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 Suite 365 Miami FL 33126-2079 Ph: (786) 322-7333 | Community Medical Group 1621 Sw 107th Ave Miami FL 33165-7344 Ph: (786) 422-6525 |
| NPI Number | 1184906646 |
|---|---|
| Provider Enumeration Date | 09/12/2011 |
| Last Update Date | 07/29/2024 |
| Medicare PECOS PAC ID | 0244477073 |
|---|---|
| Medicare Enrollment ID | O20130618000680 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184906646 | NPI | - | NPPES |
| 009426600 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Jannie Rodriguez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962807958 PECOS PAC ID: 8921907478 Enrollment ID: I20150813010935 |
| Provider Name | Leydis Morono |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1326488826 PECOS PAC ID: 9830485192 Enrollment ID: I20160913000682 |
| Provider Name | Osiel Monteserin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356791305 PECOS PAC ID: 5395014518 Enrollment ID: I20170703000717 |
| Provider Name | Marlene Cortinas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952841611 PECOS PAC ID: 2264794924 Enrollment ID: I20180319000897 |
| Provider Name | Eugenia Melida Sierra Castillo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831628189 PECOS PAC ID: 0840535811 Enrollment ID: I20181219001410 |
| Provider Name | Tamara Pena Caballero |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285116103 PECOS PAC ID: 0345588968 Enrollment ID: I20190206002036 |
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