| Jwh Miami Lakes Ii, Inc | |
|
16320 Nw 59 Ave Miami Lakes FL 33014 | |
| (305) 558-1444 | |
| (305) 558-9578 |
| Full Name | Jwh Miami Lakes Ii, Inc |
|---|---|
| Speciality | General Practice |
| Location | 16320 Nw 59 Ave, Miami Lakes, Florida |
| Authorized Official Name and Position | Justo Luis Pozo (PRESIDENT) |
| Authorized Official Contact | 3056147740 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jwh Miami Lakes Ii, Inc 2600 Douglas Rd Suite 400 Coral Gables FL 33134 Ph: (305) 614-7740 | Jwh Miami Lakes Ii, Inc 16320 Nw 59 Ave Miami Lakes FL 33014 Ph: (305) 558-1444 |
| NPI Number | 1750632972 |
|---|---|
| Provider Enumeration Date | 09/27/2012 |
| Last Update Date | 02/24/2021 |
| Medicare PECOS PAC ID | 3971754276 |
|---|---|
| Medicare Enrollment ID | O20121114000545 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750632972 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | OS004878 (Florida) | Primary |
| Provider Name | Gerardo C Perez |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1396732038 PECOS PAC ID: 2264404623 Enrollment ID: I20040807000002 |
| Provider Name | Abel Suarez Mazon |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1700414026 PECOS PAC ID: 5395107692 Enrollment ID: I20230818000717 |
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