| Memorial Primary Care Sports Medicine | |
|
1951 Sw 172nd Ave Ste 405 Miramar FL 33029-5614 | |
| (954) 265-7550 | |
| (954) 276-0250 |
| Full Name | Memorial Primary Care Sports Medicine |
|---|---|
| Speciality | Clinic/Center |
| Location | 1951 Sw 172nd Ave Ste 405, Miramar, 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 Sports Medicine 2900 Corporate Way Door D Miramar FL 33025-3925 Ph: (954) 276-5685 | Memorial Primary Care Sports Medicine 1951 Sw 172nd Ave Ste 405 Miramar FL 33029-5614 Ph: (954) 265-7550 |
| NPI Number | 1548937907 |
|---|---|
| Provider Enumeration Date | 08/24/2021 |
| Last Update Date | 08/30/2023 |
| Medicare PECOS PAC ID | 8123927373 |
|---|---|
| Medicare Enrollment ID | O20211006002486 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548937907 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
| Provider Name | Christopher G Ramsaran |
|---|---|
| Provider Type | Practitioner - Sports Medicine |
| Provider Identifiers | NPI Number: 1417158759 PECOS PAC ID: 4183899354 Enrollment ID: I20111216000377 |
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