| Country Walk Family Medicine | |
|
14261 Sw 120th St Suite 110 Miami FL 33186-7270 | |
| (305) 378-1302 | |
| (305) 378-1311 |
| Full Name | Country Walk Family Medicine |
|---|---|
| Speciality | Family Medicine |
| Location | 14261 Sw 120th St, Miami, Florida |
| Authorized Official Name and Position | Rene N Mayorga (PRESIDENT) |
| Authorized Official Contact | 3053781302 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Country Walk Family Medicine 14261 Sw 120th St Suite 110 Miami FL 33186-7270 Ph: (305) 378-1302 | Country Walk Family Medicine 14261 Sw 120th St Suite 110 Miami FL 33186-7270 Ph: (305) 378-1302 |
| NPI Number | 1659334670 |
|---|---|
| Provider Enumeration Date | 04/10/2006 |
| Last Update Date | 11/22/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659334670 | NPI | - | NPPES |
| 14292 | Other | FL | VISTA |
| 003349 | Other | FL | NEIGHBORHOOD HEALTH PART |
| 2132789 | Other | FL | AETNA |
| F00138402601 | Other | FL | NEIGBORHOOD HEALTH |
| 061439400 | Medicaid | FL | |
| 08688 | Other | FL | BLUE CROSS BLUE SHIELD |
| 0170072 | Other | FL | UNITED |
| 101635 | Other | FL | AVMED |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | ME54068 (Florida) | Primary |
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