Dedicated Ohio Holding Llc | |
1395 Nw 167th St Miami FL 33169-5710 | |
(305) 628-6117 | |
Not Available |
Full Name | Dedicated Ohio Holding 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 Ohio Holding Llc 1395 Nw 167th St Miami FL 33169-5710 Ph: (305) 628-6117 | Dedicated Ohio Holding Llc 1395 Nw 167th St Miami FL 33169-5710 Ph: (305) 628-6117 |
NPI Number | 1922631019 |
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Provider Enumeration Date | 02/17/2020 |
Last Update Date | 02/17/2020 |
Medicare PECOS PAC ID | 2769718659 |
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Medicare Enrollment ID | O20200508000335 |
Identifier | Type | State | Issuer |
---|---|---|---|
1922631019 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | (* (Not Available)) | Primary |
Provider Name | Alan C Gatz |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1588640825 PECOS PAC ID: 4587558762 Enrollment ID: I20040210000040 |
Provider Name | Lawrence M Porter |
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Provider Type | Practitioner - Emergency Medicine |
Provider Identifiers | NPI Number: 1689603995 PECOS PAC ID: 2769396365 Enrollment ID: I20040618000022 |
Provider Name | Margaret M Bigg |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1609978667 PECOS PAC ID: 1052399938 Enrollment ID: I20040708000355 |
Provider Name | Tessy Meridores |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1194991620 PECOS PAC ID: 9739169814 Enrollment ID: I20040720001625 |
Provider Name | Anisha Singh |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1881718989 PECOS PAC ID: 5890775514 Enrollment ID: I20040722001404 |
Provider Name | Joy Margaret Marshall |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1285722017 PECOS PAC ID: 4880645381 Enrollment ID: I20050202000189 |
Provider Name | Robert S Coleman |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1992781504 PECOS PAC ID: 2860447141 Enrollment ID: I20050318000921 |
Provider Name | Jennifer Casey |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1417040155 PECOS PAC ID: 7315951928 Enrollment ID: I20060203000078 |
Provider Name | Jonathan H Wynbrandt |
---|---|
Provider Type | Practitioner - Hospitalist |
Provider Identifiers | NPI Number: 1891807012 PECOS PAC ID: 9032117718 Enrollment ID: I20061113000043 |
Provider Name | Angela M Bennett |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1861495236 PECOS PAC ID: 7719080225 Enrollment ID: I20070321000060 |
Provider Name | John K Whalen |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1750343224 PECOS PAC ID: 9931100161 Enrollment ID: I20070426000352 |
Provider Name | Sergio L Mezcua |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1477621258 PECOS PAC ID: 7810053592 Enrollment ID: I20090304000493 |
Provider Name | Maneesh Lal Mehra |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1417136805 PECOS PAC ID: 9234268566 Enrollment ID: I20100525001042 |
Provider Name | Dori R Thompson |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1922012160 PECOS PAC ID: 3476683632 Enrollment ID: I20100615000008 |
Provider Name | Stacey M Fletcher |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1043542673 PECOS PAC ID: 3072759398 Enrollment ID: I20130411000195 |
Provider Name | Lynn A Gronbach |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1033418454 PECOS PAC ID: 5395961965 Enrollment ID: I20140717001696 |
Provider Name | Adam D Rhodes |
---|---|
Provider Type | Practitioner - General Practice |
Provider Identifiers | NPI Number: 1134411069 PECOS PAC ID: 4587881974 Enrollment ID: I20140807002591 |
Provider Name | Sharon Walker |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1154614733 PECOS PAC ID: 9931328267 Enrollment ID: I20140917003136 |
Provider Name | Andrea Louise Melton |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1306164553 PECOS PAC ID: 6608096466 Enrollment ID: I20140930001944 |
Provider Name | Stacy Swati Banerjee |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1871709964 PECOS PAC ID: 5890821516 Enrollment ID: I20150608001347 |
Provider Name | Vadhya Elivert |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1649531997 PECOS PAC ID: 6204129828 Enrollment ID: I20160720000228 |
Provider Name | Randall Thomas Curnow |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1922085679 PECOS PAC ID: 8628969441 Enrollment ID: I20161215002321 |
Provider Name | Nabila Babar |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1093817272 PECOS PAC ID: 2567445737 Enrollment ID: I20170607001083 |
Provider Name | Jason Adam Gregorin |
---|---|
Provider Type | Practitioner - Hospitalist |
Provider Identifiers | NPI Number: 1972982726 PECOS PAC ID: 3678877073 Enrollment ID: I20180122001806 |
Provider Name | Kimberly M Peacock |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1235541665 PECOS PAC ID: 7012206329 Enrollment ID: I20180607001603 |
Provider Name | Bradley B Backoff |
---|---|
Provider Type | Practitioner - Podiatry |
Provider Identifiers | NPI Number: 1255710596 PECOS PAC ID: 8527314319 Enrollment ID: I20180710000685 |
Provider Name | Michael Stuhler |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1578031704 PECOS PAC ID: 2668718362 Enrollment ID: I20190117001725 |
Provider Name | Michael Coffey |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1689664120 PECOS PAC ID: 7911917315 Enrollment ID: I20200707001598 |
Provider Name | James Harrington |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1265503635 PECOS PAC ID: 0941190888 Enrollment ID: I20200707002218 |
Provider Name | Hoang Phung |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1467989210 PECOS PAC ID: 8325390552 Enrollment ID: I20200714000774 |
Provider Name | Stawa Blanco |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1073126314 PECOS PAC ID: 2062839350 Enrollment ID: I20200901002566 |
Provider Name | Lisa A Robinette |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1710505110 PECOS PAC ID: 9234557075 Enrollment ID: I20200910003236 |
Provider Name | Marissel Velazquez Vicente |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1396931275 PECOS PAC ID: 8123383494 Enrollment ID: I20200916000276 |
Provider Name | Matthew Novin |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1972958072 PECOS PAC ID: 3375877749 Enrollment ID: I20201016000325 |
Provider Name | Teresa A Whitaker |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1124522693 PECOS PAC ID: 7517214273 Enrollment ID: I20210525003441 |
Provider Name | Kayla L Scheuer |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1134416191 PECOS PAC ID: 0244574499 Enrollment ID: I20210723003341 |
Provider Name | Alexander Brewer |
---|---|
Provider Type | Practitioner - Podiatry |
Provider Identifiers | NPI Number: 1588903058 PECOS PAC ID: 9931326204 Enrollment ID: I20220103000305 |
Provider Name | Allison Reinarz |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1780240085 PECOS PAC ID: 6507192911 Enrollment ID: I20220720001389 |
Provider Name | Fabian Rodriguez |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1801855192 PECOS PAC ID: 3274606017 Enrollment ID: I20220728003015 |
Provider Name | Cody Stayden |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1144943457 PECOS PAC ID: 1557737178 Enrollment ID: I20221021001245 |
Provider Name | Stefanny Santana Rivera |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1104446020 PECOS PAC ID: 5597122580 Enrollment ID: I20230607000394 |
Provider Name | Danielle Bullock |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1598394603 PECOS PAC ID: 9931522984 Enrollment ID: I20230918001892 |
Provider Name | Laura Jarrell |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1407033996 PECOS PAC ID: 3375682057 Enrollment ID: I20231111000634 |
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