| Emerald Hills Medical Center Inc | |
|
3990 Sheridan St Ste 101 Hollywood FL 33021-3655 | |
| (954) 987-4455 | |
| (954) 964-7342 |
| Full Name | Emerald Hills Medical Center Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 3990 Sheridan St Ste 101, Hollywood, Florida |
| Authorized Official Name and Position | Derwin Westerburger (OWNER) |
| Authorized Official Contact | 9545780200 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Emerald Hills Medical Center Inc 3990 Sheridan St Ste 101 Hollywood FL 33021-3655 Ph: (954) 987-4455 | Emerald Hills Medical Center Inc 3990 Sheridan St Ste 101 Hollywood FL 33021-3655 Ph: (954) 987-4455 |
| NPI Number | 1407864481 |
|---|---|
| Provider Enumeration Date | 08/04/2006 |
| Last Update Date | 11/05/2018 |
| Medicare PECOS PAC ID | 4789607813 |
|---|---|
| Medicare Enrollment ID | O20060104000509 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407864481 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | DS1649 (Florida) | Secondary |
| 207Q00000X | Family Medicine | ME94228 (Florida) | Secondary |
| 207R00000X | Internal Medicine | DS2368 (Florida) | Primary |
| Provider Name | Olga Maric |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1972581361 PECOS PAC ID: 2961493929 Enrollment ID: I20040519001291 |
| Provider Name | Renato Segura |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1356663306 PECOS PAC ID: 5991972390 Enrollment ID: I20120622000498 |
| Provider Name | Jorge E Fernandez Ramirez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1649557059 PECOS PAC ID: 8022243872 Enrollment ID: I20161107002260 |
| Provider Name | Gladys M Nogueiras |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1730578170 PECOS PAC ID: 3476832494 Enrollment ID: I20161115002714 |
| Provider Name | Bryan Lubansky |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1972042950 PECOS PAC ID: 1850646365 Enrollment ID: I20210113001009 |
| Provider Name | Evelyn Bryon |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1548767577 PECOS PAC ID: 6103226303 Enrollment ID: I20210609002112 |
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