| Waterway Med Group Llc | |
|
7001 N Waterway Dr Ste 107 Miami FL 33155-2827 | |
| (786) 542-9832 | |
| (786) 685-2585 |
| Full Name | Waterway Med Group Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 7001 N Waterway Dr Ste 107, Miami, Florida |
| Authorized Official Name and Position | Jesus Urgelles (PRESIDENT) |
| Authorized Official Contact | 7865429832 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Waterway Med Group Llc 7001 N Waterway Dr Ste 107 Miami FL 33155-2827 Ph: (786) 542-9832 | Waterway Med Group Llc 7001 N Waterway Dr Ste 107 Miami FL 33155-2827 Ph: (786) 542-9832 |
| NPI Number | 1952027104 |
|---|---|
| Provider Enumeration Date | 10/18/2022 |
| Last Update Date | 08/09/2023 |
| Medicare PECOS PAC ID | 2163894064 |
|---|---|
| Medicare Enrollment ID | O20230201003169 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952027104 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Pedro T Machin |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1972644151 PECOS PAC ID: 6709782428 Enrollment ID: I20040624000417 |
| Provider Name | Thomas Richard Lange |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1952731762 PECOS PAC ID: 8426325127 Enrollment ID: I20170601000537 |
| Provider Name | Guillermo A Fonseca |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1972700714 PECOS PAC ID: 8325308943 Enrollment ID: I20180130002505 |
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