| Ideal Care Medical Center Inc. | |
|
2188 S Jog Rd Greenacres FL 33415-6101 | |
| (561) 429-3777 | |
| (561) 429-3565 |
| Full Name | Ideal Care Medical Center Inc. |
|---|---|
| Speciality | Family Medicine |
| Location | 2188 S Jog Rd, Greenacres, Florida |
| Authorized Official Name and Position | Eduar Miguel Rios (PRESIDENT) |
| Authorized Official Contact | 5614293777 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ideal Care Medical Center Inc. 2188 S Jog Rd Greenacres FL 33415-6101 Ph: (305) 300-6447 | Ideal Care Medical Center Inc. 2188 S Jog Rd Greenacres FL 33415-6101 Ph: (561) 429-3777 |
| NPI Number | 1336747179 |
|---|---|
| Provider Enumeration Date | 10/14/2020 |
| Last Update Date | 10/14/2020 |
| Medicare PECOS PAC ID | 4284041500 |
|---|---|
| Medicare Enrollment ID | O20210401001091 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336747179 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Jerisa Berry |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1679760045 PECOS PAC ID: 8426133406 Enrollment ID: I20150609001130 |
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