| Healthra Medical Center Corp | |
|
760 Nw 107th Ave Ste 300b Miami FL 33172-3157 | |
| (786) 452-6858 | |
| Not Available |
| Full Name | Healthra Medical Center Corp |
|---|---|
| Speciality | Family Medicine |
| Location | 760 Nw 107th Ave Ste 300b, Miami, Florida |
| Authorized Official Name and Position | Carlos Rodriguez (CEO/OWNER) |
| Authorized Official Contact | 7864526858 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Healthra Medical Center Corp 760 Nw 107th Ave Ste 300b Miami FL 33172-3157 Ph: (786) 452-6858 | Healthra Medical Center Corp 760 Nw 107th Ave Ste 300b Miami FL 33172-3157 Ph: (786) 452-6858 |
| NPI Number | 1417528829 |
|---|---|
| Provider Enumeration Date | 07/07/2021 |
| Last Update Date | 04/22/2024 |
| Medicare PECOS PAC ID | 2163870130 |
|---|---|
| Medicare Enrollment ID | O20231201000120 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417528829 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QA0505X | Family Medicine - Adult Medicine | (* (Not Available)) | Primary |
| 261QC1500X | Clinic/center - Community Health | (* (Not Available)) | Secondary |
| Provider Name | Alok Harihar Dube |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1871158808 PECOS PAC ID: 0840651600 Enrollment ID: I20230727000245 |
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