| Prime Health Medical Center Llc | |
|
18250 Nw 2nd Avenue Suite 202 Miami Gardens FL 33169 | |
| (786) 280-6474 | |
| (305) 249-0072 |
| Full Name | Prime Health Medical Center Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 18250 Nw 2nd Avenue, Miami Gardens, Florida |
| Authorized Official Name and Position | Anite M Lubin (PRESIDENT) |
| Authorized Official Contact | 3059814700 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Prime Health Medical Center Llc 4724 Monroe Street Hollywood FL 33021 Ph: (305) 981-4700 | Prime Health Medical Center Llc 18250 Nw 2nd Avenue Suite 202 Miami Gardens FL 33169 Ph: (786) 280-6474 |
| NPI Number | 1750302626 |
|---|---|
| Provider Enumeration Date | 07/23/2006 |
| Last Update Date | 10/06/2008 |
| Medicare PECOS PAC ID | 4284531724 |
|---|---|
| Medicare Enrollment ID | O20031215000225 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750302626 | NPI | - | NPPES |
| 253658700 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | ME0078304 (Florida) | Secondary |
| 207R00000X | Internal Medicine | ME0071876 (Florida) | Primary |
| Provider Name | Anite M Lubin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1700861770 PECOS PAC ID: 3870490329 Enrollment ID: I20040602000364 |
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