| Executive Physicians Of South Miami | |
|
975 Baptist Way Homestead FL 33033-7600 | |
| (786) 243-8073 | |
| (786) 243-8074 |
| Full Name | Executive Physicians Of South Miami |
|---|---|
| Speciality | Internal Medicine |
| Location | 975 Baptist Way, Homestead, Florida |
| Authorized Official Name and Position | Abelardo Corona (OWNER) |
| Authorized Official Contact | 7862438073 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Executive Physicians Of South Miami Po Box 165154 Miami FL 33116-5154 Ph: (786) 243-8073 | Executive Physicians Of South Miami 975 Baptist Way Homestead FL 33033-7600 Ph: (786) 243-8073 |
| NPI Number | 1033775036 |
|---|---|
| Provider Enumeration Date | 05/15/2019 |
| Last Update Date | 10/04/2024 |
| Medicare PECOS PAC ID | 9032440680 |
|---|---|
| Medicare Enrollment ID | O20191011001302 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033775036 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Abelardo Corona |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1679558423 PECOS PAC ID: 3274510540 Enrollment ID: I20040706000067 |
| Provider Name | Mark A Hernandez |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1881679421 PECOS PAC ID: 2365429735 Enrollment ID: I20040706000116 |
| Provider Name | Francisco R Fernandez |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1629053921 PECOS PAC ID: 3577592419 Enrollment ID: I20050810000932 |
| Provider Name | David Michael Trueba |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1306876743 PECOS PAC ID: 5597721233 Enrollment ID: I20230811002346 |
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