| Medisun 62 Medical Center Llc | |
|
180 Nw 62nd St Miami FL 33150-4543 | |
| (786) 360-5625 | |
| Not Available |
| Full Name | Medisun 62 Medical Center Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 180 Nw 62nd St, Miami, Florida |
| Authorized Official Name and Position | Alexis Schloeter (MANAGER, MEMBER) |
| Authorized Official Contact | 7863505583 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Medisun 62 Medical Center Llc 180 Nw 62nd St Miami FL 33150-4543 Ph: (786) 360-5625 | Medisun 62 Medical Center Llc 180 Nw 62nd St Miami FL 33150-4543 Ph: (786) 360-5625 |
| NPI Number | 1255834594 |
|---|---|
| Provider Enumeration Date | 03/13/2018 |
| Last Update Date | 03/13/2018 |
| Medicare PECOS PAC ID | 7214287572 |
|---|---|
| Medicare Enrollment ID | O20180906002659 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255834594 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Oscar D Pozo |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1346238805 PECOS PAC ID: 2365347366 Enrollment ID: I20031203000471 |
| Provider Name | Ingrid M Mixter Leon |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1609969807 PECOS PAC ID: 1254430317 Enrollment ID: I20070702000060 |
| Provider Name | Esther Philistin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285042176 PECOS PAC ID: 3971899329 Enrollment ID: I20160910000114 |
| Provider Name | Nahir Fraga |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780173716 PECOS PAC ID: 4082966973 Enrollment ID: I20181003002320 |
| Provider Name | Niovis Garcia Fernandez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851944730 PECOS PAC ID: 8325405731 Enrollment ID: I20230530003015 |
| Provider Name | Lynda Cedent |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457810244 PECOS PAC ID: 3971960170 Enrollment ID: I20230602001465 |
| Provider Name | Bianca Dorce |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619531365 PECOS PAC ID: 5294171633 Enrollment ID: I20240307004225 |
| Provider Name | Lazaro A. Leon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124605571 PECOS PAC ID: 3476994799 Enrollment ID: I20240516003202 |
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