Landa Medical Center Corp | |
7150 W 20th Ave Ste 402 Hialeah FL 33016-5532 | |
(305) 400-8600 | |
(844) 866-4142 |
Full Name | Landa Medical Center Corp |
---|---|
Speciality | Clinic/Center |
Location | 7150 W 20th Ave Ste 402, Hialeah, Florida |
Authorized Official Name and Position | Alejandro Daniel Landa Morales (OWNER) |
Authorized Official Contact | 7864431266 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Landa Medical Center Corp 7400 W 20th Ave Apt 421 Hialeah FL 33016-1851 Ph: (786) 443-1266 | Landa Medical Center Corp 7150 W 20th Ave Ste 402 Hialeah FL 33016-5532 Ph: (305) 400-8600 |
NPI Number | 1316686942 |
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Provider Enumeration Date | 06/01/2022 |
Last Update Date | 06/18/2022 |
Medicare PECOS PAC ID | 1456797463 |
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Medicare Enrollment ID | O20240313001613 |
Identifier | Type | State | Issuer |
---|---|---|---|
1316686942 | NPI | - | NPPES |
113412000 | Medicaid | FL |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
Provider Name | Alejandro D Landa Morales |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1720740392 PECOS PAC ID: 5799178984 Enrollment ID: I20220211000168 |
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