| Excellence Healthcare, Corp | |
|
16239 Sw 88th St Miami FL 33196-4912 | |
| (786) 953-5009 | |
| (305) 503-6777 |
| Full Name | Excellence Healthcare, Corp |
|---|---|
| Speciality | Family Medicine |
| Location | 16239 Sw 88th St, Miami, Florida |
| Authorized Official Name and Position | Idania Hurtado-perez (PHYSICIAN/PRESIDENT) |
| Authorized Official Contact | 7869535009 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Excellence Healthcare, Corp 15742 Sw 100th Ter Miami FL 33196-6116 Ph: (786) 953-5009 | Excellence Healthcare, Corp 16239 Sw 88th St Miami FL 33196-4912 Ph: (786) 953-5009 |
| NPI Number | 1790247104 |
|---|---|
| Provider Enumeration Date | 04/03/2019 |
| Last Update Date | 09/27/2021 |
| Medicare PECOS PAC ID | 4385972421 |
|---|---|
| Medicare Enrollment ID | O20190827002827 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790247104 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Idania Hurtado-perez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1275840951 PECOS PAC ID: 4688897945 Enrollment ID: I20140514001497 |
| Provider Name | Antonio Fausto Diaz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831423466 PECOS PAC ID: 6204177447 Enrollment ID: I20190416001872 |
| Provider Name | Maria Julia Cigales |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790380103 PECOS PAC ID: 7517374275 Enrollment ID: I20210324001349 |
| Provider Name | Ileana Rey Orozco |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962050922 PECOS PAC ID: 9436545498 Enrollment ID: I20220331001572 |
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