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1272 Nw 119th St Miami FL 33167-3232 | |
| (305) 685-5688 | |
| (305) 687-1817 |
| Full Name | |
|---|---|
| Speciality | Internal Medicine |
| Location | 1272 Nw 119th St, Miami, Florida |
| Authorized Official Name and Position | Ventura De Paz (PRESIDENT/ CEO) |
| Authorized Official Contact | 3056855688 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
5605 Nw 82nd Ave Doral FL 33166-4000 Ph: (305) 685-5688 | 1272 Nw 119th St Miami FL 33167-3232 Ph: (305) 685-5688 |
| NPI Number | 1215981618 |
|---|---|
| Provider Enumeration Date | 05/20/2006 |
| Last Update Date | 04/02/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215981618 | NPI | - | NPPES |
| 063667306 | Medicaid | FL | |
| 063667305 | Medicaid | FL | |
| 063667310 | Medicaid | FL | |
| 063667315 | Medicaid | FL | |
| 013915000 | Medicaid | FL | |
| 063667307 | Medicaid | FL | |
| 063667313 | Medicaid | FL | |
| 063667309 | Medicaid | FL | |
| 063667314 | Medicaid | FL | |
| 063667304 | Medicaid | FL | |
| 063667311 | Medicaid | FL | |
| 063667312 | Medicaid | FL | |
| 063667316 | Medicaid | FL | |
| 063667300 | Medicaid | FL | |
| 063667308 | Medicaid | FL |
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