| Otero Medical Centers Inc | |
|
8212 W Flagler St Miami FL 33144-2028 | |
| (305) 444-7799 | |
| (305) 860-8255 |
| Full Name | Otero Medical Centers Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 8212 W Flagler St, Miami, Florida |
| Authorized Official Name and Position | Juan O. Otero (CEO) |
| Authorized Official Contact | 3054447799 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Otero Medical Centers Inc 8212 W Flagler St Miami FL 33144-2028 Ph: (305) 444-7799 | Otero Medical Centers Inc 8212 W Flagler St Miami FL 33144-2028 Ph: (305) 444-7799 |
| NPI Number | 1073758017 |
|---|---|
| Provider Enumeration Date | 12/04/2008 |
| Last Update Date | 01/29/2009 |
| Medicare PECOS PAC ID | 9133286040 |
|---|---|
| Medicare Enrollment ID | O20090320000243 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073758017 | NPI | - | NPPES |
| 251662400 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | ME77284 (Florida) | Secondary |
| 207R00000X | Internal Medicine | ME71343 (Florida) | Primary |
| Provider Name | Juan O Otero |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1760419410 PECOS PAC ID: 3072505981 Enrollment ID: I20040331001503 |
| Provider Name | Clarissa I Carbo |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1174549703 PECOS PAC ID: 2163449299 Enrollment ID: I20051028000214 |
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