| Sji Medical, P.a. | |
|
20311 Nw 7th St Pembroke Pines FL 33029-3454 | |
| (786) 897-0578 | |
| Not Available |
| Full Name | Sji Medical, P.a. |
|---|---|
| Speciality | Internal Medicine |
| Location | 20311 Nw 7th St, Pembroke Pines, Florida |
| Authorized Official Name and Position | Sergio San Jose (PRESIDENT) |
| Authorized Official Contact | 7868970578 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sji Medical, P.a. 20311 Nw 7th St Pembroke Pines FL 33029-3454 Ph: (786) 897-0578 | Sji Medical, P.a. 20311 Nw 7th St Pembroke Pines FL 33029-3454 Ph: (786) 897-0578 |
| NPI Number | 1366932527 |
|---|---|
| Provider Enumeration Date | 05/14/2018 |
| Last Update Date | 01/13/2020 |
| Medicare PECOS PAC ID | 8729325600 |
|---|---|
| Medicare Enrollment ID | O20190130002879 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366932527 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RI0200X | Internal Medicine - Infectious Disease | (* (Not Available)) | Primary |
| Provider Name | Lucila Alvarez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942545843 PECOS PAC ID: 0840425039 Enrollment ID: I20131023002260 |
| Provider Name | Ana Hernandez Casablanca |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003212226 PECOS PAC ID: 8325352099 Enrollment ID: I20150810000256 |
| Provider Name | Yurisan Rios |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578948501 PECOS PAC ID: 8022312206 Enrollment ID: I20160209000616 |
| Provider Name | Sergio San Jose |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1023307832 PECOS PAC ID: 8820389976 Enrollment ID: I20160620002153 |
| Provider Name | Zafiye Leon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023643848 PECOS PAC ID: 5193135960 Enrollment ID: I20201105001914 |
| Provider Name | Mariela Rios |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912505629 PECOS PAC ID: 6800285909 Enrollment ID: I20211111000224 |
| Provider Name | Marielys Cantillo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124722095 PECOS PAC ID: 9436419819 Enrollment ID: I20240104004752 |
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