| Memorial Primary Care 40 Aventura | |
|
20801 Biscayne Blvd Ste 201 Aventura FL 33180-1422 | |
| (305) 682-2740 | |
| (954) 276-1043 |
| Full Name | Memorial Primary Care 40 Aventura |
|---|---|
| Speciality | Family Medicine |
| Location | 20801 Biscayne Blvd Ste 201, Aventura, Florida |
| Authorized Official Name and Position | Esther Surujon (CFO MPG, MPC AND UCC) |
| Authorized Official Contact | 9542656677 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Memorial Primary Care 40 Aventura 2900 Corporate Way Door D Miramar FL 33025-3925 Ph: (954) 276-5685 | Memorial Primary Care 40 Aventura 20801 Biscayne Blvd Ste 201 Aventura FL 33180-1422 Ph: (305) 682-2740 |
| NPI Number | 1053061754 |
|---|---|
| Provider Enumeration Date | 03/25/2022 |
| Last Update Date | 04/04/2023 |
| Medicare PECOS PAC ID | 8123927373 |
|---|---|
| Medicare Enrollment ID | O20221221000336 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053061754 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Marcela Fundaminsky |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1639136252 PECOS PAC ID: 7113926106 Enrollment ID: I20070426000075 |
| Provider Name | Foluso Joy Ogunsile |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1619234242 PECOS PAC ID: 8628371267 Enrollment ID: I20230207003576 |
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