| Innovative Health | |
|
8050 N University Dr Tamarac FL 33321-2115 | |
| (786) 553-3391 | |
| (954) 998-7307 |
| Full Name | Innovative Health |
|---|---|
| Speciality | Internal Medicine |
| Location | 8050 N University Dr, Tamarac, Florida |
| Authorized Official Name and Position | Ana Ivette Gonzalez (MANAGER) |
| Authorized Official Contact | 7865533391 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Innovative Health 8050 N University Dr Tamarac FL 33321-2115 Ph: (786) 553-3391 | Innovative Health 8050 N University Dr Tamarac FL 33321-2115 Ph: (786) 553-3391 |
| NPI Number | 1265882906 |
|---|---|
| Provider Enumeration Date | 06/14/2016 |
| Last Update Date | 11/10/2022 |
| Medicare PECOS PAC ID | 1355639410 |
|---|---|
| Medicare Enrollment ID | O20161005003072 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265882906 | NPI | - | NPPES |
| ME114208 | Other | FL | MEDICAL LICENCE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (Florida) | Primary |
| Provider Name | Fernando Gonzalez Vergara |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1518276146 PECOS PAC ID: 5092954214 Enrollment ID: I20130620000064 |
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