Dedicated Columbus Ohio, Llc | |
1395 Nw 167th St Miami FL 33169-5710 | |
(305) 628-6117 | |
Not Available |
Full Name | Dedicated Columbus Ohio, Llc |
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Speciality | Internal Medicine |
Location | 1395 Nw 167th St, Miami, Florida |
Authorized Official Name and Position | Mary Chen (OWNER) |
Authorized Official Contact | 3056286117 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Dedicated Columbus Ohio, Llc 1395 Nw 167th St Miami FL 33169-5710 Ph: () - | Dedicated Columbus Ohio, Llc 1395 Nw 167th St Miami FL 33169-5710 Ph: (305) 628-6117 |
NPI Number | 1538798483 |
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Provider Enumeration Date | 04/03/2020 |
Last Update Date | 04/03/2020 |
Medicare PECOS PAC ID | 9032445929 |
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Medicare Enrollment ID | O20190730004345 |
Identifier | Type | State | Issuer |
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1538798483 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | (* (Not Available)) | Primary |
Provider Name | Rosalie Ann Kuriakose |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1699702571 PECOS PAC ID: 2961398300 Enrollment ID: I20040224000429 |
Provider Name | Sharrie A Ray |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1689751372 PECOS PAC ID: 1153368931 Enrollment ID: I20050413000499 |
Provider Name | Ariel Silva |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1346296472 PECOS PAC ID: 1052359692 Enrollment ID: I20050504000018 |
Provider Name | Deborah Lynn Wilson |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1235218637 PECOS PAC ID: 5395786552 Enrollment ID: I20050524000210 |
Provider Name | James Lawrence Canterbury |
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Provider Type | Practitioner - Podiatry |
Provider Identifiers | NPI Number: 1881709905 PECOS PAC ID: 4385661792 Enrollment ID: I20051025000823 |
Provider Name | Amit K Chatterjee |
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Provider Type | Practitioner - Hospitalist |
Provider Identifiers | NPI Number: 1417983289 PECOS PAC ID: 2264445212 Enrollment ID: I20060718000006 |
Provider Name | Laurel E Marques |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1508864604 PECOS PAC ID: 4486672623 Enrollment ID: I20060823000493 |
Provider Name | Brian L Bachelder |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1356439228 PECOS PAC ID: 2163418617 Enrollment ID: I20071008000308 |
Provider Name | H Steven Meliotes |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1194883165 PECOS PAC ID: 3678620556 Enrollment ID: I20090410000024 |
Provider Name | Jyothi Puram |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1699879189 PECOS PAC ID: 0244380707 Enrollment ID: I20090604000327 |
Provider Name | Sumit Sharma |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1306047154 PECOS PAC ID: 7911079595 Enrollment ID: I20100426000421 |
Provider Name | Mishelle L Mowry |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1831445329 PECOS PAC ID: 8729235403 Enrollment ID: I20120831000337 |
Provider Name | Lori Knight |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1548672637 PECOS PAC ID: 8426274614 Enrollment ID: I20140724000527 |
Provider Name | Karen L Staats |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1588055644 PECOS PAC ID: 9436475738 Enrollment ID: I20150304001115 |
Provider Name | Meagan Elise Weaver |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1457632408 PECOS PAC ID: 0749565760 Enrollment ID: I20170314000299 |
Provider Name | Durga Reddy Jonnalagadda |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1336550078 PECOS PAC ID: 4688961303 Enrollment ID: I20170814001913 |
Provider Name | Gloria Sefa Boateng |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1528578804 PECOS PAC ID: 6800162546 Enrollment ID: I20171024001670 |
Provider Name | Merit Israel Rutland |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1912429770 PECOS PAC ID: 2769741719 Enrollment ID: I20180119000870 |
Provider Name | Jay G Ingram |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1679968788 PECOS PAC ID: 2860700267 Enrollment ID: I20180821000856 |
Provider Name | Rasha Elhag |
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Provider Type | Practitioner - Hospitalist |
Provider Identifiers | NPI Number: 1821475054 PECOS PAC ID: 6709181969 Enrollment ID: I20181220002881 |
Provider Name | Elizabeth Repeta |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1639642416 PECOS PAC ID: 0547509192 Enrollment ID: I20190227000518 |
Provider Name | Susan Schayes |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1720183254 PECOS PAC ID: 5698806701 Enrollment ID: I20190826002243 |
Provider Name | Bhadreshkumar H Patel |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1477033389 PECOS PAC ID: 7517390933 Enrollment ID: I20191125002629 |
Provider Name | Patrick S Callender |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1922006675 PECOS PAC ID: 1153652201 Enrollment ID: I20200422001023 |
Provider Name | Ryan Brinn |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1265963292 PECOS PAC ID: 5092084806 Enrollment ID: I20200504000476 |
Provider Name | Nishant Rohit Dagli |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1194173864 PECOS PAC ID: 8325332968 Enrollment ID: I20200930001731 |
Provider Name | Jane Koroma |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1477905461 PECOS PAC ID: 3577983782 Enrollment ID: I20201008002671 |
Provider Name | Emily A Carey |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1720315625 PECOS PAC ID: 2961816087 Enrollment ID: I20210202000928 |
Provider Name | Tanner William Boes |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1013351477 PECOS PAC ID: 5496981391 Enrollment ID: I20210319001588 |
Provider Name | Sophia A Khawly |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1144573056 PECOS PAC ID: 5698913754 Enrollment ID: I20210723001283 |
Provider Name | Alexandra A Sutula |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1568968188 PECOS PAC ID: 3173873940 Enrollment ID: I20210825002101 |
Provider Name | Jill D Clay |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1306883582 PECOS PAC ID: 8022049741 Enrollment ID: I20220129000093 |
Provider Name | Kalpana Jones |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1265608004 PECOS PAC ID: 4981778073 Enrollment ID: I20220406002781 |
Provider Name | Erin P Carter |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1114421559 PECOS PAC ID: 2961759626 Enrollment ID: I20220426000816 |
Provider Name | Angel Renee Primm |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1225598295 PECOS PAC ID: 1658605654 Enrollment ID: I20220523002539 |
Provider Name | Brenna Reed |
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Provider Type | Practitioner - Podiatry |
Provider Identifiers | NPI Number: 1376106997 PECOS PAC ID: 3678800620 Enrollment ID: I20220701002761 |
Provider Name | Edgardo G Maldonado |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1346279981 PECOS PAC ID: 6507846532 Enrollment ID: I20220824000742 |
Provider Name | Elizabeth Flores |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1346976651 PECOS PAC ID: 0547636011 Enrollment ID: I20221025001816 |
Provider Name | Colin Good |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1053816959 PECOS PAC ID: 8921418203 Enrollment ID: I20231128002216 |
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