| Emmanuel Medical Center Llc | |
|
10613 Hammocks Blvd., #212 Miami FL 33196 | |
| (954) 424-1873 | |
| (954) 200-7814 |
| Full Name | Emmanuel Medical Center Llc |
|---|---|
| Speciality | General Practice |
| Location | 10613 Hammocks Blvd., #212, Miami, Florida |
| Authorized Official Name and Position | Julian N Guerrero (MEDICAL DOCTOR) |
| Authorized Official Contact | 9544241873 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Emmanuel Medical Center Llc 10613 Hammocks Blvd., #212 Miami FL 33196 Ph: (954) 424-1873 | Emmanuel Medical Center Llc 10613 Hammocks Blvd., #212 Miami FL 33196 Ph: (954) 424-1873 |
| NPI Number | 1164790986 |
|---|---|
| Provider Enumeration Date | 12/07/2011 |
| Last Update Date | 12/07/2011 |
| Medicare PECOS PAC ID | 0345404059 |
|---|---|
| Medicare Enrollment ID | O20120608000472 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164790986 | NPI | - | NPPES |
| AE622Y | Other | FL | MEDICARE |
| 278912400 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | ACN223 (Florida) | Primary |
| Provider Name | Julian N Guerrero |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1326244542 PECOS PAC ID: 0648364620 Enrollment ID: I20070921000094 |
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