| Pinecrest Total Health Llc | |
|
10420 Sw 77th Ave Ste 100 Pinecrest FL 33156-3771 | |
| (305) 877-4348 | |
| (954) 431-4246 |
| Full Name | Pinecrest Total Health Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 10420 Sw 77th Ave Ste 100, Pinecrest, Florida |
| Authorized Official Name and Position | Hugo Lara (ADMINISTRADOR) |
| Authorized Official Contact | 3058774348 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pinecrest Total Health Llc 10420 Sw 77th Ave Ste 100 Pinecrest FL 33156-3771 Ph: (305) 877-4348 | Pinecrest Total Health Llc 10420 Sw 77th Ave Ste 100 Pinecrest FL 33156-3771 Ph: (305) 877-4348 |
| NPI Number | 1124696984 |
|---|---|
| Provider Enumeration Date | 06/16/2021 |
| Last Update Date | 06/18/2021 |
| Medicare PECOS PAC ID | 7416359815 |
|---|---|
| Medicare Enrollment ID | O20210707003676 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124696984 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Erika Lara |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1407241144 PECOS PAC ID: 0446567788 Enrollment ID: I20190108003990 |
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