| Pl Roberts Id Llc | |
|
2001 W 68th St Hialeah FL 33016-1801 | |
| (786) 358-4443 | |
| (786) 685-2059 |
| Full Name | Pl Roberts Id Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 2001 W 68th St, Hialeah, Florida |
| Authorized Official Name and Position | Paul L. Roberts (OWNER/ PRESIDENT) |
| Authorized Official Contact | 7863584443 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pl Roberts Id Llc Po Box 160057 Miami FL 33116-0057 Ph: (786) 358-4443 | Pl Roberts Id Llc 2001 W 68th St Hialeah FL 33016-1801 Ph: (786) 358-4443 |
| NPI Number | 1700622412 |
|---|---|
| Provider Enumeration Date | 07/02/2024 |
| Last Update Date | 01/10/2025 |
| Medicare PECOS PAC ID | 1658818299 |
|---|---|
| Medicare Enrollment ID | O20240801000316 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700622412 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RI0200X | Internal Medicine - Infectious Disease | (* (Not Available)) | Primary |
| Provider Name | Lucila Alvarez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942545843 PECOS PAC ID: 0840425039 Enrollment ID: I20131023002260 |
| Provider Name | Yurisan Rios |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578948501 PECOS PAC ID: 8022312206 Enrollment ID: I20160209000616 |
| Provider Name | Paul L Roberts |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1104357946 PECOS PAC ID: 6507135951 Enrollment ID: I20220811002160 |
| Provider Name | Marielys Cantillo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124722095 PECOS PAC ID: 9436419819 Enrollment ID: I20240104004752 |
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