| Community Medical Group | |
|
1490 Nw 27th Ave Suite 130 Miami FL 33125-2157 | |
| (305) 635-7710 | |
| (305) 637-8122 |
| Full Name | Community Medical Group |
|---|---|
| Speciality | Family Medicine |
| Location | 1490 Nw 27th 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 1490 Nw 27th Ave Suite 130 Miami FL 33125-2157 Ph: (305) 635-7710 |
| NPI Number | 1619259264 |
|---|---|
| Provider Enumeration Date | 09/09/2011 |
| Last Update Date | 05/25/2023 |
| Medicare PECOS PAC ID | 2062659899 |
|---|---|
| Medicare Enrollment ID | O20130801000224 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619259264 | NPI | - | NPPES |
| 009426100 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Mario R Palomino |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1043229164 PECOS PAC ID: 6709772221 Enrollment ID: I20040223000964 |
| Provider Name | Amarilis Gonzalez |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1396773289 PECOS PAC ID: 1355322611 Enrollment ID: I20070122000504 |
| Provider Name | Adelfa Diaz |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1184667073 PECOS PAC ID: 3971726530 Enrollment ID: I20140529000492 |
| Provider Name | Mayra Marrero |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588089411 PECOS PAC ID: 2264656180 Enrollment ID: I20140617000340 |
| Provider Name | Tyrone J Lopez Davila |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1447696315 PECOS PAC ID: 7810297587 Enrollment ID: I20151202000672 |
| Provider Name | Jorge Fong |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629473707 PECOS PAC ID: 5698070308 Enrollment ID: I20160217002180 |
| Provider Name | Fanny L Rodriguez Ubinas |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1851466031 PECOS PAC ID: 1355423435 Enrollment ID: I20180814000661 |
| Provider Name | Ulises Barroso |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1669831855 PECOS PAC ID: 6709117377 Enrollment ID: I20191011002069 |
| Provider Name | Ramon Alejandro Paradela |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295237436 PECOS PAC ID: 1456616549 Enrollment ID: I20200324000094 |
| Provider Name | Ileana Mustelier Pomares |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1649874868 PECOS PAC ID: 4587061171 Enrollment ID: I20210923003719 |
| Provider Name | Marianela Ochoa Guevara |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497369300 PECOS PAC ID: 8527449958 Enrollment ID: I20220718000982 |
| Provider Name | Arturo Leonardo Diaz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932682911 PECOS PAC ID: 4082675806 Enrollment ID: I20240328002966 |
| Provider Name | Maytee Maria Diaz Torres |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1326726696 PECOS PAC ID: 7214375641 Enrollment ID: I20240404002270 |
| Provider Name | Niurka Pina Garcia |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336898857 PECOS PAC ID: 2365880630 Enrollment ID: I20240404004091 |
| Provider Name | Lissette Cid Medina |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043969215 PECOS PAC ID: 1557709631 Enrollment ID: I20240409002302 |
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