| Soma Medical Center Pa 12 | |
|
4775 N Congress Ave Boynton Beach FL 33426-7941 | |
| (561) 328-8631 | |
| (561) 328-8632 |
| Full Name | Soma Medical Center Pa 12 |
|---|---|
| Speciality | Internal Medicine |
| Location | 4775 N Congress Ave, Boynton Beach, Florida |
| Authorized Official Name and Position | Rafael O Nunez (PRESIDENT, MEDICAL DIRECTOR) |
| Authorized Official Contact | 5619644577 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Soma Medical Center Pa 12 4775 N Congress Ave Boynton Beach FL 33426-7941 Ph: (561) 328-8631 | Soma Medical Center Pa 12 4775 N Congress Ave Boynton Beach FL 33426-7941 Ph: (561) 328-8631 |
| NPI Number | 1558149385 |
|---|---|
| Provider Enumeration Date | 09/21/2023 |
| Last Update Date | 09/21/2023 |
| Medicare PECOS PAC ID | 3274980438 |
|---|---|
| Medicare Enrollment ID | O20231108004047 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558149385 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Rafael Baez |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1679526826 PECOS PAC ID: 4880785971 Enrollment ID: I20140820002713 |
| Provider Name | Alexi Cuellar Guerrero |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518442375 PECOS PAC ID: 7810389491 Enrollment ID: I20220111000614 |
| Provider Name | Surely Fernandez Sanchez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790308922 PECOS PAC ID: 5698111284 Enrollment ID: I20240305004261 |
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