| Carevantage Medical Centers Of Broward At Stirling Road,llc | |
|
2536 N State Road 7 Hollywood FL 33021-3205 | |
| (954) 983-8844 | |
| (954) 983-8855 |
| Full Name | Carevantage Medical Centers Of Broward At Stirling Road,llc |
|---|---|
| Speciality | General Practice |
| Location | 2536 N State Road 7, Hollywood, Florida |
| Authorized Official Name and Position | Alberto Lamadrid (OWNER) |
| Authorized Official Contact | 7866911110 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Carevantage Medical Centers Of Broward At Stirling Road,llc 2536 N State Road 7 Hollywood FL 33021-3205 Ph: (954) 983-8844 | Carevantage Medical Centers Of Broward At Stirling Road,llc 2536 N State Road 7 Hollywood FL 33021-3205 Ph: (954) 983-8844 |
| NPI Number | 1972871937 |
|---|---|
| Provider Enumeration Date | 12/06/2011 |
| Last Update Date | 01/24/2023 |
| Certification Date | 01/24/2023 |
| Medicare PECOS PAC ID | 7618107459 |
|---|---|
| Medicare Enrollment ID | O20140224000757 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972871937 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Secondary |
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| Provider Name | Noel E Lezama |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1275693137 PECOS PAC ID: 5799708731 Enrollment ID: I20060105000438 |
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