| Lara Medical Group Corp | |
|
8410 W Flagler St Ste 208b Miami FL 33144-2000 | |
| (786) 239-2753 | |
| Not Available |
| Full Name | Lara Medical Group Corp |
|---|---|
| Speciality | Family Medicine |
| Location | 8410 W Flagler St Ste 208b, Miami, Florida |
| Authorized Official Name and Position | Ricardo M Negrin Marrero (OWNER) |
| Authorized Official Contact | 7862392753 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lara Medical Group Corp 8410 W Flagler St Ste 208b Miami FL 33144-2000 Ph: (786) 239-2753 | Lara Medical Group Corp 8410 W Flagler St Ste 208b Miami FL 33144-2000 Ph: (786) 239-2753 |
| NPI Number | 1659050789 |
|---|---|
| Provider Enumeration Date | 07/17/2023 |
| Last Update Date | 07/17/2023 |
| Medicare PECOS PAC ID | 2961864962 |
|---|---|
| Medicare Enrollment ID | O20230808001442 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659050789 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Ricardo M Negrin Marrero |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174143556 PECOS PAC ID: 8820489552 Enrollment ID: I20220107000675 |
| Provider Name | Robert H Kim |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1265923841 PECOS PAC ID: 0446637524 Enrollment ID: I20220510002552 |
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