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18356 Nw 47th Ave Miami Gardens FL 33055-2934 | |
| (305) 974-5750 | |
| (305) 757-4443 |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 18356 Nw 47th Ave, Miami Gardens, Florida |
| Authorized Official Name and Position | Comfort Omobola Adewumi (PRESIDENT/PHYSICIAN DIRECTOR/OWNER) |
| Authorized Official Contact | 3057574442 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
17439 Nw 66th Ct Hialeah FL 33015-4431 Ph: (305) 974-5750 | 18356 Nw 47th Ave Miami Gardens FL 33055-2934 Ph: (305) 974-5750 |
| NPI Number | 1154611036 |
|---|---|
| Provider Enumeration Date | 04/13/2011 |
| Last Update Date | 12/30/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154611036 | NPI | - | NPPES |
| 275310300 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | OS8579 (Florida) | Primary |
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