Sagrado Corazon Medical Center Llc | |
700 E 1st Avenue Hialeah FL 33010-4645 | |
(786) 488-4301 | |
(786) 534-2917 |
Full Name | Sagrado Corazon Medical Center Llc |
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Speciality | Family Medicine |
Location | 700 E 1st Avenue, Hialeah, Florida |
Authorized Official Name and Position | Carlos Alberto Diaz Valladares (MEMBER/OWNER) |
Authorized Official Contact | 7864884301 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Sagrado Corazon Medical Center Llc 700 E 1st Avenue Hialeah FL 33010-4645 Ph: (305) 200-5532 | Sagrado Corazon Medical Center Llc 700 E 1st Avenue Hialeah FL 33010-4645 Ph: (786) 488-4301 |
NPI Number | 1043882061 |
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Provider Enumeration Date | 07/12/2021 |
Last Update Date | 06/26/2023 |
Medicare PECOS PAC ID | 8325436546 |
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Medicare Enrollment ID | O20211020002810 |
Identifier | Type | State | Issuer |
---|---|---|---|
1043882061 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Provider Name | Juan P Nunez |
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Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1255869491 PECOS PAC ID: 3274877535 Enrollment ID: I20181128000835 |
Provider Name | Carlos Diaz Valladares |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1215506878 PECOS PAC ID: 4082793500 Enrollment ID: I20211020002052 |
Provider Name | Aida Viera |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1811562234 PECOS PAC ID: 3476941600 Enrollment ID: I20211103000592 |
Provider Name | Olga Johanna Morgan |
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Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1003509936 PECOS PAC ID: 6608238795 Enrollment ID: I20230822002217 |
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