| St Michael Medical Center Inc | |
|
620 Ne 128th St North Miami FL 33161-4829 | |
| (305) 981-1015 | |
| (305) 981-1016 |
| Full Name | St Michael Medical Center Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 620 Ne 128th St, North Miami, Florida |
| Authorized Official Name and Position | Joseph M Lemaire (PRESIDENT) |
| Authorized Official Contact | 3059811015 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| St Michael Medical Center Inc 620 Ne 128th St North Miami FL 33161-4829 Ph: (305) 981-1015 | St Michael Medical Center Inc 620 Ne 128th St North Miami FL 33161-4829 Ph: (305) 981-1015 |
| NPI Number | 1235156910 |
|---|---|
| Provider Enumeration Date | 07/17/2006 |
| Last Update Date | 01/28/2008 |
| Medicare PECOS PAC ID | 7315089810 |
|---|---|
| Medicare Enrollment ID | O20100121000650 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235156910 | NPI | - | NPPES |
| 273166500 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QA0505X | Family Medicine - Adult Medicine | ME0065663 (Florida) | Primary |
| Provider Name | Joseph M Lemaire |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1235183757 PECOS PAC ID: 3375568744 Enrollment ID: I20051014000129 |
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