| Care Fusion Clinic Llc | |
|
12030 Sw 129th Ct Ste 103 Miami FL 33186-4584 | |
| (954) 366-3348 | |
| Not Available |
| Full Name | Care Fusion Clinic Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 12030 Sw 129th Ct Ste 103, Miami, Florida |
| Authorized Official Name and Position | Yennys Valdes Garces (OWNER) |
| Authorized Official Contact | 9543663348 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Care Fusion Clinic Llc 12030 Sw 129th Ct Ste 103 Miami FL 33186-4584 Ph: (786) 701-8892 | Care Fusion Clinic Llc 12030 Sw 129th Ct Ste 103 Miami FL 33186-4584 Ph: (954) 366-3348 |
| NPI Number | 1689493645 |
|---|---|
| Provider Enumeration Date | 10/07/2024 |
| Last Update Date | 11/25/2025 |
| Certification Date | 11/25/2025 |
| Medicare PECOS PAC ID | 3870027998 |
|---|---|
| Medicare Enrollment ID | O20241112004381 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689493645 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Damisela Amador Jimenez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124527734 PECOS PAC ID: 5092053850 Enrollment ID: I20190221000039 |
| Provider Name | Alok Harihar Dube |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1871158808 PECOS PAC ID: 0840651600 Enrollment ID: I20230727000245 |
| Provider Name | Dayana Mendez |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1003352279 PECOS PAC ID: 4082063177 Enrollment ID: I20231214002670 |
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