| Cosme Medical Center Llc | |
|
8742 Sw 161st Ave Miami FL 33193-5403 | |
| (786) 543-7403 | |
| Not Available |
| Full Name | Cosme Medical Center Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 8742 Sw 161st Ave, Miami, Florida |
| Authorized Official Name and Position | Cosme Jose Llerena (ARNP/OWNER) |
| Authorized Official Contact | 7865437403 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cosme Medical Center Llc 8742 Sw 161st Ave Miami FL 33193-5403 Ph: (786) 543-7403 | Cosme Medical Center Llc 8742 Sw 161st Ave Miami FL 33193-5403 Ph: (786) 543-7403 |
| NPI Number | 1609605328 |
|---|---|
| Provider Enumeration Date | 07/31/2024 |
| Last Update Date | 07/31/2024 |
| Medicare PECOS PAC ID | 7416496211 |
|---|---|
| Medicare Enrollment ID | O20240824000007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609605328 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Lissette Dominguez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710505482 PECOS PAC ID: 0749691517 Enrollment ID: I20201130001601 |
| Provider Name | Cosme J Llerena |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275151169 PECOS PAC ID: 1658593223 Enrollment ID: I20230327001489 |
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