| Lake Worth Medical Clinic Corp | |
|
6295 Lake Worth Rd Ste 30 Greenacres FL 33463-3034 | |
| (561) 377-7006 | |
| Not Available |
| Full Name | Lake Worth Medical Clinic Corp |
|---|---|
| Speciality | Family Medicine |
| Location | 6295 Lake Worth Rd Ste 30, Greenacres, Florida |
| Authorized Official Name and Position | Rosa Maria Smith (PRESIDENT) |
| Authorized Official Contact | 5616607399 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lake Worth Medical Clinic Corp 6295 Lake Worth Rd Ste 30 Greenacres FL 33463-3034 Ph: (561) 660-7399 | Lake Worth Medical Clinic Corp 6295 Lake Worth Rd Ste 30 Greenacres FL 33463-3034 Ph: (561) 377-7006 |
| NPI Number | 1881220861 |
|---|---|
| Provider Enumeration Date | 03/21/2020 |
| Last Update Date | 03/28/2023 |
| Medicare PECOS PAC ID | 7911376017 |
|---|---|
| Medicare Enrollment ID | O20221213000362 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881220861 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Denise M Josey |
|---|---|
| Provider Type | Practitioner - Preventive Medicine |
| Provider Identifiers | NPI Number: 1376801589 PECOS PAC ID: 3274806070 Enrollment ID: I20190408000272 |
| Provider Name | Fabio Mariano Mehrgut |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1174504690 PECOS PAC ID: 7012337348 Enrollment ID: I20201026001463 |
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