| Dedicated Missouri Holding, Llc | |
|
1395 Nw 167th St Miami Gardens FL 33169-5710 | |
| (305) 628-6117 | |
| Not Available |
| Full Name | Dedicated Missouri Holding, Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1395 Nw 167th St, Miami Gardens, Florida |
| Authorized Official Name and Position | Mary Chen (AUTHORIZED OFFICIAL) |
| Authorized Official Contact | 3058314722 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dedicated Missouri Holding, Llc 1395 Nw 167th St Miami Gardens FL 33169-5710 Ph: (305) 628-6117 | Dedicated Missouri Holding, Llc 1395 Nw 167th St Miami Gardens FL 33169-5710 Ph: (305) 628-6117 |
| NPI Number | 1053958082 |
|---|---|
| Provider Enumeration Date | 12/10/2019 |
| Last Update Date | 10/31/2024 |
| Medicare PECOS PAC ID | 5395176820 |
|---|---|
| Medicare Enrollment ID | O20200515001886 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053958082 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Olujoke B Jones |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1629028667 PECOS PAC ID: 5092609032 Enrollment ID: I20051003000443 |
| Provider Name | Tisha D Anyanike |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1144370750 PECOS PAC ID: 3173626017 Enrollment ID: I20080411000666 |
| Provider Name | Fredrick M Kuhlmann |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1417981481 PECOS PAC ID: 6507801107 Enrollment ID: I20090203000016 |
| Provider Name | Anthony Joseph Healy |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1245452705 PECOS PAC ID: 2264598176 Enrollment ID: I20090302000230 |
| Provider Name | David Michael Glick |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1679557177 PECOS PAC ID: 8123217866 Enrollment ID: I20110111000302 |
| Provider Name | Myrna I Gover Havener |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1487664942 PECOS PAC ID: 3173785060 Enrollment ID: I20120511000098 |
| Provider Name | Delora Brooks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659622330 PECOS PAC ID: 9537311808 Enrollment ID: I20121212000625 |
| Provider Name | Lee P Bee |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1669429908 PECOS PAC ID: 8325079361 Enrollment ID: I20131002000642 |
| Provider Name | Josephine La Glaser |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1407887979 PECOS PAC ID: 1052446754 Enrollment ID: I20150518001297 |
| Provider Name | Anne U Jacob |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1033107636 PECOS PAC ID: 9638257215 Enrollment ID: I20150623001975 |
| Provider Name | Peter S Groce |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245637271 PECOS PAC ID: 4789953035 Enrollment ID: I20170630000528 |
| Provider Name | Deanna Justine Bajala |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1689038077 PECOS PAC ID: 5395039887 Enrollment ID: I20191019000066 |
| Provider Name | Charlotte Lin Chang |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1578083515 PECOS PAC ID: 7618248568 Enrollment ID: I20200515001945 |
| Provider Name | Andrea V. Caraccioli |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1083057970 PECOS PAC ID: 6608155932 Enrollment ID: I20200521001450 |
| Provider Name | Kunal Gurav |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1033434576 PECOS PAC ID: 1254623036 Enrollment ID: I20200526000789 |
| Provider Name | Susan Schayes |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1720183254 PECOS PAC ID: 5698806701 Enrollment ID: I20200608002664 |
| Provider Name | Andrew Davis |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1184153140 PECOS PAC ID: 5991048860 Enrollment ID: I20200723000983 |
| Provider Name | Kharole Compere |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1598299646 PECOS PAC ID: 2860811171 Enrollment ID: I20201005002770 |
| Provider Name | Indolfo Alberto Luna |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1629560891 PECOS PAC ID: 9739580853 Enrollment ID: I20210628001263 |
| Provider Name | Matthew Fieleke |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1467680900 PECOS PAC ID: 8123275823 Enrollment ID: I20220715002022 |
| Provider Name | Shalaunda Gray |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1467545863 PECOS PAC ID: 9830168384 Enrollment ID: I20220803002398 |
| Provider Name | Poovizhi Selvi Velmurugan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497340483 PECOS PAC ID: 4183007131 Enrollment ID: I20220824000760 |
| Provider Name | Joel E Meyer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1689652752 PECOS PAC ID: 6507031382 Enrollment ID: I20221101002783 |
| Provider Name | Manjula Cherukuri |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1477632016 PECOS PAC ID: 1850493743 Enrollment ID: I20221121002549 |
| Provider Name | Thomas Joseph |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1457734808 PECOS PAC ID: 4385990498 Enrollment ID: I20230105000621 |
| Provider Name | Melissa Blake |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518425651 PECOS PAC ID: 9739420704 Enrollment ID: I20230109002223 |
| Provider Name | Michael E Engel |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1861431983 PECOS PAC ID: 7315089091 Enrollment ID: I20230310001964 |
| Provider Name | Shari Lynn Samms |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1245337500 PECOS PAC ID: 8921320565 Enrollment ID: I20230504002024 |
| Provider Name | Andrea G Brown |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1548897499 PECOS PAC ID: 4981020179 Enrollment ID: I20230530002968 |
| Provider Name | Vincent Viet Ngo |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1730703117 PECOS PAC ID: 4880054238 Enrollment ID: I20230717001435 |
| Provider Name | Beatrice Deshommes |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1659382414 PECOS PAC ID: 0244239937 Enrollment ID: I20230724003777 |
| Provider Name | Latha Cherath |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1134446859 PECOS PAC ID: 9032347117 Enrollment ID: I20230821001868 |
| Provider Name | Chia-yuan Hsu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1154909828 PECOS PAC ID: 0547603276 Enrollment ID: I20240208004229 |
| Provider Name | Timothy Hutchison |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1881636702 PECOS PAC ID: 9133123433 Enrollment ID: I20240213000179 |
| Provider Name | Angie Harris |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1972694685 PECOS PAC ID: 5193621233 Enrollment ID: I20240227003063 |
| Provider Name | James Harrington |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1265503635 PECOS PAC ID: 0941190888 Enrollment ID: I20240605000716 |
Family Med Choice, Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 18356 Nw 47th Ave, Miami Gardens, FL 33055 Phone: 305-620-7155 | |
Medcare Centers, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4767 Nw 183rd St, Miami Gardens, FL 33055 Phone: 305-266-2929 Fax: 786-558-0242 | |
Jessie Trice Community Health System Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 20612 Nw 27th Ave, Miami Gardens, FL 33056 Phone: 305-637-6400 Fax: 305-805-1715 | |
Ciartes Medical Center Corp Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 18350 Nw 2nd Ave Ste 622, Miami Gardens, FL 33169 Phone: 786-985-4752 | |
Aaron Medical Group Corp Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 19509 Nw 57th Ave, Miami Gardens, FL 33055 Phone: 754-465-3003 Fax: 866-552-0934 | |
Spetro And Associates Corp Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 99 Nw 183rd St, Miami Gardens, FL 33169 Phone: 786-230-3577 | |
Alive And Well Community Partners Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 18425 Nw 2nd Ave 5th Floor Ph 7, Miami Gardens, FL 33169 Phone: 800-434-1366 |