| Luis Del Prado Md Pa Corp | |
|
420 Sw 133rd Pl Miami FL 33184-1131 | |
| (786) 541-4727 | |
| Not Available |
| Full Name | Luis Del Prado Md Pa Corp |
|---|---|
| Speciality | Family Medicine |
| Location | 420 Sw 133rd Pl, Miami, Florida |
| Authorized Official Name and Position | Luis Del Prado (PRESIDENT) |
| Authorized Official Contact | 7862289926 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Luis Del Prado Md Pa Corp 420 Sw 133rd Pl Miami FL 33184-1131 Ph: () - | Luis Del Prado Md Pa Corp 420 Sw 133rd Pl Miami FL 33184-1131 Ph: (786) 541-4727 |
| NPI Number | 1235567744 |
|---|---|
| Provider Enumeration Date | 10/18/2013 |
| Last Update Date | 03/14/2024 |
| Medicare PECOS PAC ID | 9436387198 |
|---|---|
| Medicare Enrollment ID | O20140102001385 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235567744 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | ME116945 (Florida) | Primary |
| Provider Name | Rancel Rodriguez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326382599 PECOS PAC ID: 9931344306 Enrollment ID: I20130408000234 |
| Provider Name | Luis Del Prado |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1619230612 PECOS PAC ID: 4385871813 Enrollment ID: I20131209000453 |
| Provider Name | Idalberto J Tejeda Rodriguez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639657471 PECOS PAC ID: 4587902465 Enrollment ID: I20190219002635 |
| Provider Name | Jose Miguel Fonseca Alfonso |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346912367 PECOS PAC ID: 6507204658 Enrollment ID: I20240409001367 |
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