| Family Physicians Of Kendall Llc | |
|
11160 Sw 88th St Suite #104 & #105 Miami FL 33176-0949 | |
| (786) 263-0911 | |
| (786) 263-2761 |
| Full Name | Family Physicians Of Kendall Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 11160 Sw 88th St, Miami, Florida |
| Authorized Official Name and Position | Norma S Lake (OWNER) |
| Authorized Official Contact | 7862630911 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Family Physicians Of Kendall Llc 11160 Sw 88th St Suite #104 & #105 Miami FL 33176-0949 Ph: (786) 263-0911 | Family Physicians Of Kendall Llc 11160 Sw 88th St Suite #104 & #105 Miami FL 33176-0949 Ph: (786) 263-0911 |
| NPI Number | 1952585796 |
|---|---|
| Provider Enumeration Date | 12/27/2007 |
| Last Update Date | 07/02/2008 |
| Medicare PECOS PAC ID | 9032270681 |
|---|---|
| Medicare Enrollment ID | O20081202000165 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952585796 | NPI | - | NPPES |
| 0637962 | Other | OH | AETNA |
| 080130460 | Other | OH | RAILROAD MEDICARE |
| 01-03310 | Other | OH | UNITED HEALTH CARE |
| 0151642 | Medicaid | OH | |
| 000000141284 | Other | OH | ANTHEM BLUE CROSS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | ME 81467 (Florida) | Primary |
| Provider Name | Norma S Lake |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1912906686 PECOS PAC ID: 3678634227 Enrollment ID: I20081202000156 |
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