| Core Concierge Health And Wellness Llc | |
|
2550 S Bayshore Dr Ste 204 Miami FL 33133-4743 | |
| (305) 210-2673 | |
| Not Available |
| Full Name | Core Concierge Health And Wellness Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 2550 S Bayshore Dr Ste 204, Miami, Florida |
| Authorized Official Name and Position | Ketevan Leo (OWNER) |
| Authorized Official Contact | 9177534770 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Core Concierge Health And Wellness Llc 2550 S Bayshore Dr Ste 204 Miami FL 33133-4743 Ph: (917) 753-4770 | Core Concierge Health And Wellness Llc 2550 S Bayshore Dr Ste 204 Miami FL 33133-4743 Ph: (305) 210-2673 |
| NPI Number | 1285312694 |
|---|---|
| Provider Enumeration Date | 07/06/2023 |
| Last Update Date | 03/14/2024 |
| Medicare PECOS PAC ID | 4284085929 |
|---|---|
| Medicare Enrollment ID | O20240108003491 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285312694 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Ketevan Leo |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1750521571 PECOS PAC ID: 9335286830 Enrollment ID: I20091031000066 |
| Provider Name | Kristen Doddo |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1558516641 PECOS PAC ID: 3870780885 Enrollment ID: I20101202001164 |
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