S & L Healthy Corp | |
14255 Sw 42nd St Ste 13b Miami FL 33175-6408 | |
(305) 219-8606 | |
Not Available |
Full Name | S & L Healthy Corp |
---|---|
Speciality | Family Medicine |
Location | 14255 Sw 42nd St Ste 13b, Miami, Florida |
Authorized Official Name and Position | Lizet Lopez (PRESIDENT) |
Authorized Official Contact | 3052198606 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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S & L Healthy Corp 14255 Sw 42nd St Ste 13b Miami FL 33175-6408 Ph: () - | S & L Healthy Corp 14255 Sw 42nd St Ste 13b Miami FL 33175-6408 Ph: (305) 219-8606 |
NPI Number | 1104408624 |
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Provider Enumeration Date | 04/23/2021 |
Last Update Date | 10/11/2021 |
Medicare PECOS PAC ID | 6103222062 |
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Medicare Enrollment ID | O20210901002614 |
Identifier | Type | State | Issuer |
---|---|---|---|
1104408624 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
208D00000X | General Practice | (* (Not Available)) | Secondary |
261Q00000X | Clinic/center | (* (Not Available)) | Secondary |
Provider Name | Bradley R Drury |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1487975975 PECOS PAC ID: 0547542870 Enrollment ID: I20190621001354 |
Provider Name | Lizet Lopez |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1215485354 PECOS PAC ID: 9931487857 Enrollment ID: I20201118001226 |
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