| Valencia Medical Center, Inc | |
|
9804 Sw 40th St Miami FL 33165-3912 | |
| (305) 222-9154 | |
| (305) 222-9155 |
| Full Name | Valencia Medical Center, Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 9804 Sw 40th St, Miami, Florida |
| Authorized Official Name and Position | Judith Valencia (PRESIDENT) |
| Authorized Official Contact | 3052229154 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Valencia Medical Center, Inc 9804 Sw 40th St Miami FL 33165-3912 Ph: (305) 222-9154 | Valencia Medical Center, Inc 9804 Sw 40th St Miami FL 33165-3912 Ph: (305) 222-9154 |
| NPI Number | 1649598418 |
|---|---|
| Provider Enumeration Date | 05/04/2010 |
| Last Update Date | 11/04/2022 |
| Medicare PECOS PAC ID | 1355725144 |
|---|---|
| Medicare Enrollment ID | O20220827000598 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649598418 | NPI | - | NPPES |
| PQ912 | Other | FL | MEDICARE |
| 115804400 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | ME98844 (Florida) | Primary |
| Provider Name | Judith Valencia |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1649478389 PECOS PAC ID: 2860581022 Enrollment ID: I20071211000406 |
| Provider Name | Aimee Hernandez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952993826 PECOS PAC ID: 9335525492 Enrollment ID: I20220928000160 |
| Provider Name | Joel L De La Torre |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124452339 PECOS PAC ID: 7618353145 Enrollment ID: I20221006000139 |
| Provider Name | Manuel M Cabrera |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912573858 PECOS PAC ID: 7214127422 Enrollment ID: I20221107002198 |
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