| Nuestra Sra Del Carmen | |
|
141 N 6th St Haines City FL 33844-4207 | |
| (407) 201-7918 | |
| (863) 438-6624 |
| Full Name | Nuestra Sra Del Carmen |
|---|---|
| Speciality | General Practice |
| Location | 141 N 6th St, Haines City, Florida |
| Authorized Official Name and Position | Jaime Jorge-flores (CEO) |
| Authorized Official Contact | 4072678823 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Nuestra Sra Del Carmen 141 N 6th St Haines City FL 33844-4207 Ph: (863) 353-1538 | Nuestra Sra Del Carmen 141 N 6th St Haines City FL 33844-4207 Ph: (407) 201-7918 |
| NPI Number | 1619225067 |
|---|---|
| Provider Enumeration Date | 08/16/2012 |
| Last Update Date | 05/22/2024 |
| Medicare PECOS PAC ID | 6002065018 |
|---|---|
| Medicare Enrollment ID | O20121008000654 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619225067 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| 261QC1800X | Clinic/center - Corporate Health | HCC10049 (Florida) | Secondary |
| Provider Name | Jaime Jorge Flores |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1043273519 PECOS PAC ID: 2466641626 Enrollment ID: I20121008000636 |
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