| Smc Medical Center, Inc. | |
|
11373 Sw 211th St Ste 16 Miami FL 33189-2247 | |
| (305) 234-0009 | |
| (305) 234-8688 |
| Full Name | Smc Medical Center, Inc. |
|---|---|
| Speciality | Family Medicine |
| Location | 11373 Sw 211th St Ste 16, Miami, Florida |
| Authorized Official Name and Position | Raymond Levy (PRESIDENT) |
| Authorized Official Contact | 3052529485 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Smc Medical Center, Inc. 9780 E Indigo St Ste 202 Palmetto Bay FL 33157-5610 Ph: (305) 252-9485 | Smc Medical Center, Inc. 11373 Sw 211th St Ste 16 Miami FL 33189-2247 Ph: (305) 234-0009 |
| NPI Number | 1346327848 |
|---|---|
| Provider Enumeration Date | 11/01/2006 |
| Last Update Date | 03/13/2017 |
| Medicare PECOS PAC ID | 5597785352 |
|---|---|
| Medicare Enrollment ID | O20051123000229 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346327848 | NPI | - | NPPES |
| 016833600 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Nora Daniel |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1720183106 PECOS PAC ID: 2365514098 Enrollment ID: I20160729001600 |
| Provider Name | Barbara Matos |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326766197 PECOS PAC ID: 0648656686 Enrollment ID: I20221014000632 |
| Provider Name | Indira Beatriz Gutierrez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083345094 PECOS PAC ID: 3476926460 Enrollment ID: I20230222000150 |
| Provider Name | Katia Miranda Calnick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144941378 PECOS PAC ID: 1951759562 Enrollment ID: I20231120003665 |
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