| Integrum Medical Group, Llc | |
|
8756 Sw 72nd St Miami FL 33173-3512 | |
| (786) 384-1150 | |
| Not Available |
| Full Name | Integrum Medical Group, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 8756 Sw 72nd St, Miami, Florida |
| Authorized Official Name and Position | Raul A Gonzalez (MANAGING PARTNER) |
| Authorized Official Contact | 7863841150 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Integrum Medical Group, Llc 8756 Sw 72nd St Miami FL 33173-3512 Ph: (786) 384-1150 | Integrum Medical Group, Llc 8756 Sw 72nd St Miami FL 33173-3512 Ph: (786) 384-1150 |
| NPI Number | 1770053761 |
|---|---|
| Provider Enumeration Date | 12/03/2018 |
| Last Update Date | 12/03/2018 |
| Medicare PECOS PAC ID | 8527393107 |
|---|---|
| Medicare Enrollment ID | O20190718002845 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770053761 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Rita M Carralero |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1427190289 PECOS PAC ID: 4880831619 Enrollment ID: I20130925000789 |
| Provider Name | Katia I Almaguer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861924235 PECOS PAC ID: 7214270586 Enrollment ID: I20190530001159 |
| Provider Name | Sandro Hernandez Alfonso |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790444370 PECOS PAC ID: 8820489594 Enrollment ID: I20220107000313 |
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