| Intercontinental Medical Network Inc | |
|
3271 Nw 7th St Suite 206 Miami FL 33125-4141 | |
| (305) 649-7511 | |
| (305) 649-7505 |
| Full Name | Intercontinental Medical Network Inc |
|---|---|
| Speciality | General Practice |
| Location | 3271 Nw 7th St, Miami, Florida |
| Authorized Official Name and Position | Marjorie J Bowen (PRESIDENT) |
| Authorized Official Contact | 3056497511 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Intercontinental Medical Network Inc 3271 Nw 7th St Suite 206 Miami FL 33125-4141 Ph: (305) 649-7511 | Intercontinental Medical Network Inc 3271 Nw 7th St Suite 206 Miami FL 33125-4141 Ph: (305) 649-7511 |
| NPI Number | 1922043777 |
|---|---|
| Provider Enumeration Date | 06/17/2006 |
| Last Update Date | 10/26/2022 |
| Medicare PECOS PAC ID | 1153218946 |
|---|---|
| Medicare Enrollment ID | O20041020001054 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922043777 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (Florida) | Primary |
| Provider Name | Myriam D Lacayo |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1265472468 PECOS PAC ID: 9739080763 Enrollment ID: I20040114000223 |
| Provider Name | Lianet Ibarra |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336645407 PECOS PAC ID: 5799030078 Enrollment ID: I20180611001939 |
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