| |
6350 Sunset Dr South Miami FL 33143-4836 | |
(305) 253-5100 | |
(305) 252-5811 |
Full Name | |
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Speciality | Clinic/Center |
Location | 6350 Sunset Dr, South Miami, Florida |
Authorized Official Name and Position | Blake Hall (PRESIDENT/CEO) |
Authorized Official Contact | 3052524853 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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10300 Sw 216th St Cutler Bay FL 33190-1003 Ph: (305) 253-5100 | 6350 Sunset Dr South Miami FL 33143-4836 Ph: (305) 253-5100 |
NPI Number | 1336583004 |
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Provider Enumeration Date | 04/24/2013 |
Last Update Date | 08/29/2024 |
Medicare PECOS PAC ID | 6507770526 |
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Medicare Enrollment ID | O20130905000909 |
Identifier | Type | State | Issuer |
---|---|---|---|
1336583004 | NPI | - | NPPES |
029572877 | Medicaid | FL | |
029572875 | Medicaid | FL | |
060303115 | Medicaid | FL |
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