| Harbour Medical And Aesthetics Center Llc | |
|
1021 Ives Dairy Rd Ste 214 Miami FL 33179-2537 | |
| (305) 504-6136 | |
| Not Available |
| Full Name | Harbour Medical And Aesthetics Center Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 1021 Ives Dairy Rd Ste 214, Miami, Florida |
| Authorized Official Name and Position | Gretel Trullenque (AUTHORIZED OFFICIAL) |
| Authorized Official Contact | 3055046136 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Harbour Medical And Aesthetics Center Llc 1021 Ives Dairy Rd Ste 214 Miami FL 33179-2537 Ph: (305) 504-6136 | Harbour Medical And Aesthetics Center Llc 1021 Ives Dairy Rd Ste 214 Miami FL 33179-2537 Ph: (305) 504-6136 |
| NPI Number | 1659031946 |
|---|---|
| Provider Enumeration Date | 12/28/2021 |
| Last Update Date | 06/09/2022 |
| Medicare PECOS PAC ID | 0345634580 |
|---|---|
| Medicare Enrollment ID | O20220303001518 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659031946 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Gretel Trullenque |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1720076144 PECOS PAC ID: 8527015510 Enrollment ID: I20050401000284 |
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