| Professional Medical Services & Management Inc. | |
|
315 W 9th St Fl 2 Hialeah FL 33010-3853 | |
| (786) 360-4528 | |
| (786) 360-4529 |
| Full Name | Professional Medical Services & Management Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 315 W 9th St Fl 2, Hialeah, Florida |
| Authorized Official Name and Position | Sandy Lopez (PRESIDENT/ CEO) |
| Authorized Official Contact | 7863604528 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Professional Medical Services & Management Inc. 315 W 9th St Second Floor Hialeah FL 33010-3853 Ph: (786) 360-4528 | Professional Medical Services & Management Inc. 315 W 9th St Fl 2 Hialeah FL 33010-3853 Ph: (786) 360-4528 |
| NPI Number | 1417233222 |
|---|---|
| Provider Enumeration Date | 10/25/2011 |
| Last Update Date | 01/25/2022 |
| Medicare PECOS PAC ID | 4082879309 |
|---|---|
| Medicare Enrollment ID | O20120711000194 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417233222 | NPI | - | NPPES |
| ME51845 | Other | FL | MEDICAL LICENSE |
| 000645500 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (Florida) | Secondary |
| 261Q00000X | Clinic/center | (* (Not Available)) | Secondary |
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
| Provider Name | Omar Abreu-pino |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891190526 PECOS PAC ID: 1850467820 Enrollment ID: I20150319001926 |
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