| |
19001 Sw 106th Ave Unit C109 Cutler Bay FL 33157-7669 | |
(305) 964-5425 | |
(305) 964-5465 |
Full Name | |
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Speciality | Family Medicine |
Location | 19001 Sw 106th Ave Unit C109, Cutler Bay, Florida |
Authorized Official Name and Position | Vivian T Giraldo (OWNER) |
Authorized Official Contact | 3054974007 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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19001 Sw 106th Ave Unit C109 Cutler Bay FL 33157-7669 Ph: (305) 964-5425 | 19001 Sw 106th Ave Unit C109 Cutler Bay FL 33157-7669 Ph: (305) 964-5425 |
NPI Number | 1336836170 |
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Provider Enumeration Date | 04/21/2023 |
Last Update Date | 08/25/2023 |
Medicare PECOS PAC ID | 8729442595 |
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Medicare Enrollment ID | O20240625002063 |
Identifier | Type | State | Issuer |
---|---|---|---|
1336836170 | NPI | - | NPPES |
Provider Name | Carmen Rosa Amador |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1144855388 PECOS PAC ID: 4183046808 Enrollment ID: I20200625000045 |
Provider Name | Vivian Tatiana Giraldo |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1699436048 PECOS PAC ID: 0547624314 Enrollment ID: I20230912002626 |
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