Otto L Secada Mdpa | |
7150 W 20th Ave Ste 209 Hialeah FL 33016-5531 | |
(305) 828-5677 | |
(305) 828-9196 |
Full Name | Otto L Secada Mdpa |
---|---|
Speciality | Internal Medicine |
Location | 7150 W 20th Ave Ste 209, Hialeah, Florida |
Authorized Official Name and Position | Otto L Secada (PHYSICIAN) |
Authorized Official Contact | 3058285677 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Otto L Secada Mdpa 7150 W 20th Ave Ste 209 Hialeah FL 33016-5531 Ph: (305) 828-5677 | Otto L Secada Mdpa 7150 W 20th Ave Ste 209 Hialeah FL 33016-5531 Ph: (305) 828-5677 |
NPI Number | 1881983658 |
---|---|
Provider Enumeration Date | 04/01/2011 |
Last Update Date | 09/19/2022 |
Medicare PECOS PAC ID | 7618151044 |
---|---|
Medicare Enrollment ID | O20110411000144 |
Identifier | Type | State | Issuer |
---|---|---|---|
1881983658 | NPI | - | NPPES |
057633600 | Medicaid | FL |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207RG0300X | Internal Medicine - Geriatric Medicine | ME60146 (Florida) | Primary |
Provider Name | Otto L Secada |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1942297205 PECOS PAC ID: 2062696404 Enrollment ID: I20110425000194 |
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