| Innovative Care Ii, Llc | |
|
12600 Pembroke Rd Suite 100 Miramar FL 33027-2544 | |
| (954) 843-7230 | |
| (877) 671-4101 |
| Full Name | Innovative Care Ii, Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 12600 Pembroke Rd, Miramar, Florida |
| Authorized Official Name and Position | Gokhan Guvenli (MEDICAL DIRECTOR) |
| Authorized Official Contact | 9544509595 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Innovative Care Ii, Llc 1 Sw 129th Ave Ste 304 Pembroke Pines FL 33027-1717 Ph: (954) 843-7230 | Innovative Care Ii, Llc 12600 Pembroke Rd Suite 100 Miramar FL 33027-2544 Ph: (954) 843-7230 |
| NPI Number | 1790086023 |
|---|---|
| Provider Enumeration Date | 11/03/2010 |
| Last Update Date | 07/21/2022 |
| Medicare PECOS PAC ID | 1850562893 |
|---|---|
| Medicare Enrollment ID | O20120525000524 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790086023 | NPI | - | NPPES |
| BW654Z | Other | FL | MEDICARE |
| FJ749A | Other | FL | MEDICARE PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | OS10374 (Florida) | Primary |
| Provider Name | Sonia Madera |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1548531981 PECOS PAC ID: 1759522840 Enrollment ID: I20130801000557 |
| Provider Name | Luis Gabriel Cedeno Abreu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1457703977 PECOS PAC ID: 3173865102 Enrollment ID: I20230712003414 |
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