| Del Prado Medical Center Inc | |
|
2500 Del Prado Blvd S Cape Coral FL 33904-5750 | |
| (239) 772-1194 | |
| (239) 772-1196 |
| Full Name | Del Prado Medical Center Inc |
|---|---|
| Speciality | General Practice |
| Location | 2500 Del Prado Blvd S, Cape Coral, Florida |
| Authorized Official Name and Position | Daisy Martinez (OWNER/PRESIDENT) |
| Authorized Official Contact | 2397721194 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Del Prado Medical Center Inc 2500 Del Prado Blvd S Cape Coral FL 33904-5750 Ph: (239) 772-1194 | Del Prado Medical Center Inc 2500 Del Prado Blvd S Cape Coral FL 33904-5750 Ph: (239) 772-1194 |
| NPI Number | 1982855359 |
|---|---|
| Provider Enumeration Date | 10/03/2008 |
| Last Update Date | 07/29/2024 |
| Medicare PECOS PAC ID | 7618039496 |
|---|---|
| Medicare Enrollment ID | O20090105000294 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982855359 | NPI | - | NPPES |
| BD041 | Other | FL | MEDICARE |
| 022008300 | Medicaid | FL | |
| 022008301 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| 261Q00000X | Clinic/center | (* (Not Available)) | Secondary |
| Provider Name | Daisy Maria Jay |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1194828392 PECOS PAC ID: 6204881618 Enrollment ID: I20050318000395 |
| Provider Name | Alejandro Barreda Vidal |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1285072553 PECOS PAC ID: 7113205915 Enrollment ID: I20161029000223 |
| Provider Name | Soraida Tamayo Leyva |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407422397 PECOS PAC ID: 1355730870 Enrollment ID: I20211122001934 |
| Provider Name | Damaso Alberto Maresma |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932845609 PECOS PAC ID: 5294102331 Enrollment ID: I20221103000038 |
| Provider Name | Marian V Enrich Rodriguez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124744545 PECOS PAC ID: 1153784731 Enrollment ID: I20230830000513 |
| Provider Name | Diana Aguirre |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366221988 PECOS PAC ID: 6204273782 Enrollment ID: I20240319004048 |
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