| Soma Medical Center Pa 14 | |
|
3129 S Congress Ave Palm Springs FL 33461-2551 | |
| (561) 964-4577 | |
| Not Available |
| Full Name | Soma Medical Center Pa 14 |
|---|---|
| Speciality | Internal Medicine |
| Location | 3129 S Congress Ave, Palm Springs, 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 14 3129 S Congress Ave Palm Springs FL 33461-2551 Ph: (561) 964-4577 | Soma Medical Center Pa 14 3129 S Congress Ave Palm Springs FL 33461-2551 Ph: (561) 964-4577 |
| NPI Number | 1558140384 |
|---|---|
| Provider Enumeration Date | 09/21/2023 |
| Last Update Date | 09/21/2023 |
| Medicare PECOS PAC ID | 3072959865 |
|---|---|
| Medicare Enrollment ID | O20240315000432 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558140384 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Rafael Orlando Nunez |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1043208895 PECOS PAC ID: 5395753552 Enrollment ID: I20110121001036 |
| Provider Name | Israel Junquera Camargo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487272316 PECOS PAC ID: 3577955178 Enrollment ID: I20220111001452 |
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