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714 Nw 62nd St Miami FL 33150-4332 | |
| (786) 655-0529 | |
| (786) 558-7308 |
| Full Name | |
|---|---|
| Speciality | Internal Medicine |
| Location | 714 Nw 62nd St, Miami, Florida |
| Authorized Official Name and Position | William Mayhood (LEGAL & REGULATORY) |
| Authorized Official Contact | 8773846337 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
714 Nw 62nd St Miami FL 33150-4332 Ph: (786) 655-0529 | 714 Nw 62nd St Miami FL 33150-4332 Ph: (786) 655-0529 |
| NPI Number | 1124581632 |
|---|---|
| Provider Enumeration Date | 04/11/2019 |
| Last Update Date | 06/24/2024 |
| Medicare PECOS PAC ID | 0547696452 |
|---|---|
| Medicare Enrollment ID | O20200212000527 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124581632 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| 261Q00000X | Clinic/center | (* (Not Available)) | Secondary |
| Provider Name | Alade Afolabi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124161260 PECOS PAC ID: 8820077506 Enrollment ID: I20040715001441 |
| Provider Name | Sarah L Skelly |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1881013886 PECOS PAC ID: 9032482666 Enrollment ID: I20170901002811 |
| Provider Name | Adrian Lopez Truy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396213062 PECOS PAC ID: 7810310927 Enrollment ID: I20200708002076 |
| Provider Name | Yolanda Collada |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619439874 PECOS PAC ID: 4688022890 Enrollment ID: I20231129000918 |
| Provider Name | Yovany Gongora |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962140434 PECOS PAC ID: 7618318205 Enrollment ID: I20240514002367 |
| Provider Name | Ashley Rigsby |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538938774 PECOS PAC ID: 2264978188 Enrollment ID: I20240726001545 |
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