| Latino Medical Center Iv, Inc | |
|
12800-12880 Nww 7th Ave North Miami FL 33168 | |
| (786) 636-6183 | |
| (786) 657-2623 |
| Full Name | Latino Medical Center Iv, Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 12800-12880 Nww 7th Ave, North Miami, Florida |
| Authorized Official Name and Position | Rodney Joseph (PRESIDENT) |
| Authorized Official Contact | 3058799526 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Latino Medical Center Iv, Inc 12800-12880 Nww 7th Ave North Miami FL 33168 Ph: (786) 636-6183 | Latino Medical Center Iv, Inc 12800-12880 Nww 7th Ave North Miami FL 33168 Ph: (786) 636-6183 |
| NPI Number | 1629688304 |
|---|---|
| Provider Enumeration Date | 08/06/2020 |
| Last Update Date | 08/06/2020 |
| Medicare PECOS PAC ID | 9234504002 |
|---|---|
| Medicare Enrollment ID | O20230408000152 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629688304 | NPI | - | NPPES |
| 010902500 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Mario A Delgado-fernandez |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1275589772 PECOS PAC ID: 6103922299 Enrollment ID: I20070507000373 |
| Provider Name | Arnaldo Villafranca |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1205886488 PECOS PAC ID: 0840485876 Enrollment ID: I20101116000423 |
| Provider Name | Rene Coto Borges |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1821407826 PECOS PAC ID: 2163707399 Enrollment ID: I20170330000252 |
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